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| Effect of Sequential Invasive-Non-Invasive Sequential Mechanical Ventilation on COPD Patients with Type II Respiratory Failure and Pulmonary Heart Disease |
| GAO Jing, TENG Haifeng |
| Weihai Municipal Hospital, Shandong Weihai 264200, China |
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Abstract Objective: To discuss the effects of two different mechanical ventilation (invasive-non-invasive sequential mechanical ventilation and simple invasive mechanical ventilation) on blood gas, pulmonary function and ventilator associated pneumonia (VAP) in patients with chronic obstructive pulmonary disease (COPD) complicated with type II respiratory failure and pulmonary heart disease. Methods: From December 2017 to December 2018, 70 patients with COPD with pulmonary heart disease complicated with type Ⅱ respiratory failure were randomly divided into two groups: test group (n = 35) and control group (n=35). In the control group, 35 patients were given mechanical ventilation by endotracheal intubation first. After reaching the indication of non-invasive ventilation, the test group was changed to non-invasive mask mechanical ventilation, and the control group continued to be treated with simple invasive mechanical ventilation. Systolic blood pressure (SBP), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), pH, heart rate (HR), pulmonary function, mortality and VAP were measured before and after treatment in two groups. The incidence, the total duration of mechanical ventilation and the length of hospitalization were compared and analyzed. Results: There was no significant difference in SBP,PaO2,PaCO2, PH and HR between the two groups before and after treatment (P>0.05). The levels of SBP,PaO2, PH after treatment in both groups were significantly higher than those before treatment(t=-1.39,-2.99,-9.75,-12.60,-8.36,-8.36, all P<0.05), and the levels of HR and PaCO2 were lower than those before treatment (t=5.44,8.26,7.19,10.80, all P<0.05). There was no significant difference in pulmonary function between the two groups before treatment (P>0.05), but the pulmonary function indexes in two groups after treatment were significantly higher than those before the treatment (t=-2.69,-3.67, -5.45,-5.38, all P<0.05). The incidence of VAP in test group was 2.80. %, significantly lower than 20.00% in control group (χ2= 5.814, P<0.05), and the duration of mechanical ventilation in the test group was significantly shortened compared with control group (t = 5.196, P<0.05). The hospitalization time in test group was significantly lower than that in control group, and there was no significant difference in the mortality between the two groups (P>0.05). Conclusion: Invasive-non-invasive sequential mechanical ventilation can improve pulmonary function and reduce the incidence of ventilator-associated pneumonia in patients with COPD complicated with cor pulmonale with type Ⅱ respiratory failure. It is worthy of promotion and application in clinic.
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2021, Vol. 27 
