The Study Of Treating Hypercapnic Respiratory Failure Due To Chronic Obstructive Pulmonary Disease Using Bronchoalveolar Lavage Combined With Noninvasive Positive Pressure Ventilation

Objective:To study effects and safety of conbining noninvasive positive pressure ventilation with hronchoalveolar lavage treating patients with hypercapnic respiratory failure(typeâ…¡)caused by chronic obstructive pulmonary disease(COPD).Methods: 53Patients with hypercapnic respiratory failure caused by COPD which did not recover after 2 hours'treating with only noninvasive positive pressure ventilation were randomly divided into two groups,A group went on taking noninvasive positive pressure ventilation, B group were given bronchoalveolar lavage before taking noninvasive positive pressure ventilation.Arterial blood gas values,heart rate,respiratory rate,average arterial pressure, APACHEâ…¡score,temperature,RICU-days,IPAP pressure and side effect were measured before and after intervention.Results:PaCO₂ decreased both in two groups but the level of PaCO₂ in B group was lower than that in A group,The significance within two groups occurred earher(P＜0.05);PaO₂ increased in both groups but the level of it in B group was higher than that in A group,especially at 24^thhrs and 2^ndday(P＜0.05);Heart rate, average arterial pressure and APACHEâ…¡score in both groups were not significant during the whole intervention periods(P＞0.05);The level of Temperature in B group at 12^thhrs was higher than that of A group(P＜0.05)but was not significant at 24^thhrs.The level of IPAP needed in B group was lower than that of A group(P＜0.05).RICU-days,intubation rate and incidence of tympanites and oronasal ulcers in B group were lower than that of A group(P＜0.05).Conclusion:Treatment using noninvasive positive pressure ventilation combined with bronchoalveolar lavage can make patients with hypercapnic respiratory failure due to COPD decrease PaCO₂,RICU-days and intubation rate more quickly than that using noninvasive positive pressure ventilation only.