Analysis Of Factors Associated With Failure Of Noninvasive Positive Pressure Ventilation In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:To explore the related factors of noninvasive positive pressure ventilation(NPPV) failure in acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with respiratory failure.Methods:The clinical data of85AECOPD patients presenting with type II respiratory failure were analyzed retrospectively. According to the curative effect of NPPV,patients were divided into success group and failure group.The physiological and biochemical indicators,Acute Physiology Assessment and Chronic Health Evaluation (APACHE) II score and Glasgow Coma Score(GCS) on admission were compared before treatment,and frequency of complications of NPPV,the changes of the arterial blood after two hours of NPPV were analyzed comparatively.Results:(1)In failure group the pretreatment APACHE-â…¡ score,serum C-reactive protein level on admission and frequency of complications of NPPV were significantly higher and GCS was significantly lower than in success group(P<0.05).(2)Before treatment of NPPV,there was no significant difference in pH and PaCO2between two groups(P>0.05),after two hours of NPPV,in significant difference in pH and PaCO2between two groups(P>0.05),after two hours of NPPV,in success group pH was significantly higher and PaCO2was significantly lower than in failure group(P<0.05).(3)There was significant increase of pH and decrease of PaCO2in success group at admission and after two hours of NPPV(P<0.05),while there was no significant change in failure group(P>0.05).Conclusion:High APACHE-â…¡ score and low GCS,presence of complications of NPPV and no improvement in pH and PaCO2after two hours of NPPV are associated risk factors with NPPV failure. Patients with these risk factors should be considered a need of early invasive ventilation.