A Study Of Noninvasive Positive Pressure Ventilation On Respiratory Failure Of Chronic Obstructive Pulmonary Disease

Objective:To evaluate the value of noninvasive positive pressure ventilation (NIPPV) on respiratory failure in acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods:Forty-eight patients with respiratory failure of chronic obstructive pulmonary disease from February in 2008 to October in 2009 in Respiratory Ward of the First affiliated hospital of Dalian Medical Univer-sity were included in the study, of them,24 patients received NIPPV plus "standard care" (such as taking antibiotics, glucocorticoids, eliminating phlegm, receiving continual low-flow oxygen and maintaining acid-base balance). Another 24 patients only received "standard care". Changes of clinical manifestation and arterial blood gas were observed. Compare trachea intubation rate, and the death rate, the average days between the two groups.Results:Two cases of the standard-care group refused to receive ventilation treatment and died in the hospital. Six cases of the standard-care group received ventilation treatment and get better. Four cases of the NIPPV group were given trachea cannel and were relieved, one case refused to receive the invasive ventilation and died at last. The trachea intubation rate of the two groups were 25% and 16.7% respectively, the average days stay in the hospital were 28±14 days and 23±12 days respectively, the death rate were 8.3% and 4.17% respectively. The NIPPV group significantly reduced the need for endotracheal intubation, the in-hospital mortality rate and the mean hospital stay. There was no marked difference in blood gas indexes, heart rate, breath frequency between Oh and 2h in the standard-care group (P> 0.05), but there was a significant difference in the NIPPV group (P<0.05). The use of NIPPV significantly decreased the PaCO2 level and respiratory rates, but significantly increased the PaO2 level after 2 hours of treatment. There was marked difference in both groups after 24h and 72h treatment (P<0.05). Compare with the results of the standard-care group, NIPPV group improved significantly in blood gas indexes, heart rate and breath frequency(P<0.05).Conclusion:The results suggest that NIPPV can improve the gas exchange, can achieve exact curative effect, and control trachea cannel rate and hospital mortality, reduce the length of stay, save medical resource. And non-invasive positive pressure ventilation is an effective ventilatory support in the patients with respiratory failure due to an acute exacerbation of COPD.