The Application Of Non-Invasive Positive Pressure Ventilation In Sequential Non-Invasive Following Invasive Mechanical Ventilation In The Patient Of COPD

Objective: Investigate the efficacy of Non-Invasive Positive Pressure Ventilation in sequential mechanical ventilation in COPD patients with excerbate respritory failure at the time"Pulmonary Infection Control"window. Method: Select sixteen patients with excerbate Respiratory Failure from January 2009 to March 2010 in RICU and EICU of the First-attach Hospital of XJ medical University,treated by tracheal intubation connected with invasive mechanical ventilation as study group,extubation when the"Pulmonary Infection Control Window"appeared , sequential Non-Invasive Positive Pressure Ventilation with face mask,gradually to wean.The number of male is 10 ,female 6,average age 71.8.Choose fifteen patients in the same period with the same condition as the control group,continue invasive mechanical ventilation when the"Pulmonary Infection Control window"appeared,use the way of PSV to wean. The number of male is 9 ,female 6,average age 73.6. Compare the blood gas alleosis of two group,observe the the time of invasive mechanical ventilation and total ventilation; days in RICU; re-intubation rate; death rate and the incidence of Ventilators-Associated Pneumonia (VAP) of two groups. Result: There was no significant difference of the base circumstance and blood gas analysis between the two groups,﹙P >0.05﹚,also the same at the piont"Pulmonary infection control window",﹙P >0.05﹚. Compared with control group,the success weaning rate is more higher, the incidence of Ventilators-Associated Pneumonia (VAP),death rate and re-intubation rate is more lower,less invasive mechanical ventilation time and days in RICU.﹙P<0.05﹚.But the total mechanical ventilation time was no difference.﹙P >0.05﹚.Conclusion: AS to the acute exacerbate COPD patiens treated by tracheal intubation connected with invasive mechanical ventilation caused by pulmonary infection,use the strategy of early extubation sequential non-invasive following short-term invasive mechanical ventilation at the piont of PIC window, can significantly improve the curative effect. Obviouslly cut down the re-intubation rate and death rate. Lessen the pain and the cost of patient. This is a safe,economics,effective treating strategy.