Effects of bi-level positive airway pressure treatment in elder moderate-severe chronic obstructive pulmonary disease patients with upper abdominal surgery in postoperative period

Abstract

Objective To investigate the treatment effects of noninvasive bi-level positive airway Dressure(BiPAP)in elder chronic obstructive pulmonary disease(COPD)patients with upper abdominal surgery in postoperative period.Methods To divide 59 moderate-severe elder stable COPD patients into two groups randomly.Thirty cases in treatment group,intermittent noninvasive BiPAP was added on the basis of general treatment,began to use one week before the surgery and continued to use after the surgery for one week(to use immediately in general anesthesia patients after extubation).Twenty-nine cases in control group,to cure with the general method of removing sputum,relieving caugh and stopping dyspnea in postoperative period.Results PaO2,FEV1,PEFR increased obviously before the surgery in treatment group [PaO2:(77.3±4.2)mm Hg vs(86.4±4.7)mm Hg,FEV1:(1.02±0.11)L/s vs(1.37±0.21)L/s,PEFR:(3.47±0.29)L/s vs(4.84±0.34)L/s](P＜0.05).PaO2,PEFR decreased in varying degrees in both groups after the surgery,and the degree was more obvious in control group than in treatment group (P＜0.05).Parameters began to recover in the second day after the surgery in treatment group,and reached to the normal level in the fifth day,but got tO the normal level in the seventh day in control group.The incidence rate of pulmonary complications was more obvious in control group than in treatment group(20%vs 37.9%),the duration of hospitalization was shorter in treatment group than in control group(9.46 days vs 13.36 days)(P＜0.05).Conclusions The restricted air-flow and hypoxemia can be improved significantly in elder COPD patients with upper abdominal surgery in postoperative period after treatment with nonin-vasive BiPAP increases ventilation,decreases complications after surgery. Key words: Postoperation; Bi-level positive airway pressure; Chronic obstructive pulmonary disease; Treatment Pffeet