A Study Of The Relationship Of Critical Respiratory Failure And Respiratory Failure In Patiens With Chronic Obstructive Diseases

Objective:With PaO₂ for classification of severity of chronic obstructive pulmonary diseases(COPD),the stages of severity were graded into : insufficient critical respiratory failure, critical respiratory failure, respiratory failure.To study their raletive.Methods:Compare arterial gases(ABGs),peaceful respiratory drive, mechanics of respiratory muscles,BODE index and some important cytokines of these patients("insufficient critical respiratory failure "critical respiratory failure" , "respiratory failure") with control group, and then analyze the relationships ofthese parameters and their power. Results:1 .Arterial blood gas and lung function: there was statistics difference in arterial partialpressure of oxygen level in the four groups.In respiratory failure group, carbon dioxide partial pressure was significantly increased,higher than that in the other three groups.2.Cytokine: In "critical respiratory failure"group and respiratory failure group ,IL-8 has not statistics differences ,but was markedly higher than that in other two groups. TGFβ1,in control group,was lower than that in other three groups ,the TGFp1 level in respiratory failure group was not markedly higher compared with that in "critical respiratory failure"group.There was no statistics difference in IL-1β level between "critical respiratory failure"group and respiratory failure group. In "critical respiratory failure"group and respiratory failure group, IL-1βwas markedly higher than that in other two groups. 3.Respiratory muscular fatigue: There was no statistics difference in PIMAX levelbetween control group and insufficient critical respiratory failure group.The PIMAX level in respiratory failure group ,was lower than that in critical respiratory failure.The lactic acid lever in respiratory failure group was markedly higher than that in other three groups.4.Center respiration drive:The P0.1 level in respiratory failure group was markedly higher than that in other three groups.5. BODE index:BODE index in "critical respiratory failure" group was markedly higher than that in insufficient "critical respiratory failure" group. There was no statistics difference in BODE index between "critical respiratory failure"group and respiratory failure group. Conclusions:l.COPD " critical respiratory failure " stage was to get worse in airway obstruction,airway remodeling,airway inflammation, respiratory muscular fatigue, center respiration drive and prognosis than those in insufficient " critical respiratory failure " stage. So this critical respiratory failure can be scientific and can be used in clinical medication.2.There was statistics difference in center respiration drive and respiratory muscular fatigue level between "critical respiratory failure"stage and respiratory failure stage, respiratory muscular fatigue was important factor that induced respiratory failure. 3.We deduced the regression equation:PaO2=47.132+15.549FEVi%+8.147PIMAX-0.522PaCO2-0.227IL8-3.9931act. We may intervene the progress when these patients in this special stage before they go into the stage of True Respiratory Failure". The intervention ought to be concentrated on the therapies of oxygenation, bronchodilators, avoiding respiratory muscles fatigue, cytokines and anti-infection.