The Assessment of Effects of Noninvasive Mechanical Ventilation Application on Markers of Muscle Injury and Ischemia

Abstract

The noninvasive mechanical ventilation (NIMV) is widely used for the treatment of the patients’ chronic obstructive pulmonary disease (COPD) and respiratory failure. noninvasive mechanical ventilationis effective in increasing the ventilation of the lungs and decreasing the work of the heart on the left ventricle and the consumption of the oxygen. In spite of the positive effects of the noninvasive mechanical ventilationtreatment, an increase of cardiac damage is seen in the patients . The aim of this study is to search certain ischemia markers in order to assess and measure the impact of this treatment on the striated muscle and the cardiac muscle of the patients who have been tied to the noninvasive mechanical ventilator, due to their suffering from the difficulty of breathing. With this objective, 64 patients with the diagnosis of COPD are included in this research, and they are divided into two groups. Group I (control group, n=31) consists of the patients who are suffering from mild respiratory failure and not connected to the ventilator. The patients with the severe respiratory failure, prior to their being tied to the ventilator, constitute Group II (before ventilation (vö)) (n=33), after their having been connected to the ventilator (3rd day), are the members of Group II (after ventilation (vs)) (n=33). The levels of blood pH, pO2 and pCO2, serum troponin, myoglobin, creatine kinase (CK), CKMB, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), albumin, and the ischemia modified albumin (IMA) have been measured in the patients. The level of serum troponin has been observed higher in prior to NIMV (Group II (vö)) than control group (Group I). Likewise, it has been noted significant increase in group after NIMV (Group II (vs)). Serum AST and IMA has also been seen a significant increase in group after NIMV (Group II (after)) as compared to the control group (Group I). There was no significant difference among the groups at the levels of serum myoglobin, CK-MB, ALT, CK, LDH (p>0.05). It was concluded that, depending on the severity of respiratory failure, that are markers of ischemia, serum troponin, AST and IMA levels increased, NIMV application contributed to this increase is limited and cardiac function more careful should be followed during the non-invasive mechanical ventilation application.