Clinical Analysis Of Sequential No-invasive Following Invasive Mechanical Ventilation In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective to study the therapeutic effective in early stage of invasive ventilation extubation and sequential no-invasive ventilation in acute exacerbation of COPD. Methods:The patients need mechanical ventilation were diagnosised the acute exacerbation of COPD were divided into sequential group and control group randomly,and 18patient in sequential group ,18patient in control group. in the beginning, A/C model controlled ventilation was adopted in invasive ventilation .and then SIMV+PSV model was taken, then,reduce SIMV and PSV gradually,until 10 times/minute and10cmH2O in sequential group, at the same time,if the pulmonary infection control window appeared,the early extubation was conducted and followed by no-invasive ventilation. on the other hand ,the control group reduce SIMV and PSV until 5times/minute and 5cmH2O,and then extubation.the duration of ICU stay , the duration of mechanical ventilation,the incidence of ventilation-associated pneumonia, the rate of weaning success and the rate of mortality were examined . Results for sequential group and control group ,the duration of ICU was(14±7)days vs(25±15)days,(P<0.05),the total duration of mechanical ventilation was (14±7)days vs(22±15)days,(P<0.05),the incidence of VAP were 0/18vs 9/18,and the rate of mortility were 2/18 vs 4/18 (P>0.05). Conclusion in the acute exacerbation of COPD requiring sequential no-invasive following invasive mechanical ventilation at the point of pulmonary infection control window may decrease the duration of ICU stay, total duration of mechanical ventilation and the risk of VAP.