INVASIVE MECHANICAL VENTILATION WITH HIGH CONCENTRATION OXYGEN THERAPY FOR AECOPD PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Abstract

SESSION TITLE: Topics in Obstructive Lung Disease SESSION TYPE: Original Investigations PRESENTED ON: 10/23/2019 02:15 PM - 03:15 PM PURPOSE: To evaluate the efficacy of invasive ventilation with high concentration oxygen for AECOPD patients with acute myocardial infarction（AMI）. METHODS: It was a randomized and prospective controlled trial,87 elderly AECOPD patients were included, who complicated with AMI,who could not accept PCI,80 cases (92%)with congestive heart failure), the shock and malignant arrhythmia were excluded. All subjects were divided into(1:1:1) three groups depending on therapy. Conventional oxygen therapy group (3-7L/min, via nasal catheter);high concentration oxygen group: invasive ventilation with PRVC mode, management of FiO2 included two steps: Step 1:FiO2:50%-70% within 48 hours; Step 2: FiO2 from 50% to 40% gradually after the 48th hour, moderate concentration oxygen group: invasive ventilation with PRVC mode, FiO2:30%-50%.All groups were received Heparin Sodium continuous venous pump(100IU/kg/d), anti-anxiety and expansion of coronary therapy, etc. RESULTS: 14-day mortality rate and occurrence of malignant arrhythmia in high concentration oxygen group were lower than other groups <0.01). Compared with moderate-concentration oxygen, there was a higher extubation rate (75.9% vs. 44.8%, p=0.016). Recurrence rate of myocardial Infarction were 31.0% (n=9) and 6.9% (n=2) in moderate and high concentration oxygen group respectively (p=0.019). There was no difference in occurrence of hyperoxia among groups (p>0.05). CONCLUSIONS: There was significant improvement in mortality rate and extubation for AECOPD patients with AMI who accepted invasive ventilation with high concentration oxygen therapy than in moderate-concentration oxygen group. CLINICAL IMPLICATIONS: AECOPD patients with AMI maybe benefit from invasive ventilation with high concentration oxygen therapy, and seems to be an appropriate therapy for these patients who could not undergo PCI, but which potential impacts need further study. DISCLOSURES: no disclosure on file for Boxue Han; No relevant relationships by Jiao Jun, source=Web Response no disclosure on file for Fuzhou Liu; no disclosure on file for Lei Sun; no disclosure on file for Ying Wang; no disclosure on file for Guoru Yang