Non-invasive Positive Pressure Ventilation In Idiopathic Pulmonary Fibrosis Treatment Of Respiratory Failure

ObjectiveInvestigating the clinical course andoutcome of patients with non-invasive positive pressure ventilation treatment, observing the effection of non-invasive positive pressure ventilation on idiopathic pulmonary fibrosis and respiratory failure patients.Methods41 IPF patients [M/F=29/12; age=(60.67±7.83) years] due to respiratory failure were selected from the Department of Respiratory & Intensive Treatment Unit of our hospital from July 2009 to December 2010, who all met the diagnostic criteria for IPF according to American Thoracic Society and European Society of Respiratory Diseases in 2000, depending on the non-surgery (thoracotomy or VATS) lung biopsy evidence of diagnostic criteria for IPF. In those 11 cases of acute onset, and other 30 cases were chronic process. All patients had various degrees of dyspnea after activity, according to indications of non-invasive mechanical ventilation. This group of patients had no obvious airway secretions given NIPPV therapy, and had the ability of clearing airway secretions spontaneously and strong independent breathing capacity. Selecing mask connection the Siemens Servo-S mechanical ventilation, appropriate combination with plus temperature and humidity of the device in the course of treatment. Analyzing the clinical symptoms quality of life, the changes in arterial blood gas before and after treatment, observing the adverse effects and treatment efficiency mortality. Comparing arterial blood gases before treatment with 2h after treatment and 24h after treatment of NIPPV and analyzed them statistically. Expressed Parameter data with mean±standard deviation (x±s), application SPSS 16.0 software process the data, comparison of the periods with paired t test, a= 0.05 as a test.Results1.33 in 41 patients on the machine treament after 4h were to symptoms of respiratory difficultie reduced in varying degrees, subsidedclinical remission rate was 80.5%.Quality of life in 12 cases improved, Oropharyngeal drying and bloating as the main side effects.2. After 2 hours NIPPV treatment PaO2, PaCO2, and SpO2, rebounded significantly (P＜0.001, P<0.05, P＜0.001), After 24 hours NIPPV treatment PaO2, PaCO2, and SpO2, rebounded significantly (P＜0.001,P＜0.001, P<0.001), NIPPV after 24h and 2h compared arterial blood gas, PaO2, SPO2 and PaCO2 was not significantly different (P> 0.05)3. Cause of respiratory failure in 22 cases were pulmonary infection,13 cases (31.7%) treatment success; the other 19 cases all were killed for idiopathic pulmonary fibrosis, acute exacerbation or lungs disease has progressed to end-stage patients,28 cases failured of NIPPV,10 cases of them changed invasive mechanical ventilation were killed, mortality 68.3%(28/41).Conclusion1. NIPPV can ease the IPF due to severe hypoxemia and tissue and organ hypoxia, early application can ease symptoms and improve quality of life.2. IPF induced pulmonary infection of respiratory failure patients, Part of the lung function in the compensatory stage,Application of noninvasive mechanical ventilation to control the infection to correct respiratory failure to win time. 3. Acute exacerbation of IPF, or lungs disease has progressed to end-stage patients, the outcome can not effectively change with non-invasive ventilation fails to invasive ventilation.