Home Noninvasive Positive Pressure Ventilation In Chronic Obstructive Pulmonary Disease With Type Ⅱ Respiratory Failure In Acute Exacerbation Effect Analysis

Objective: We observe and discuss bilevel positive airway pressure (BiPAP)breathing apparatus’operability and curative effect in domestic treatment for chronicobstructive pulmonary disease (COPD) by COPD patients with type2respiratoryfailure that are in hospital and see the cognitive degree and compliance of patients tothis disease. We want to seek for some evidence for carrying for health education andpopularizing domestic noninvasive ventilator.Methods:1. According to the diagnostic criteria of COPD that lay down by Chinese MedicalAssociation’s branch of respiratory disease（2007）, we collect33patients that are inhospital as the result of acute exacerbation of COPD with type2respiratory failure fromFeb2010to Feb2012in The municipal central hospital of Dalian Medical University.The patients’ blood gas analysis meet following conditions that is PaCO2>50mmHgPaO2<60mmHg with or without disturbance of consciousness(slight coma, somnolenceapathy).They accept the non-invasive positive pressure ventilation and get better andleave hospital and do long-term domiciliary oxygen therapy using BiPAP breathingapparatus for more than one year. Our exclusive criteria are With asthma dyspnea andabnormal pulmonary function that caused by Respiratory tract infection, cardiacdyspnea, bronchial asthma, lung bronchogenic carcinoma interstitial lung disease, acutepulmonary embolismetal.2. We do follow up visit by telephone family questionnaire and back to hospitalregularly. We do some study statistics and analysis to the correlation index of acceptingBiPAP breathing apparatus for one year in29patients. We also know the problems inusing non-invasive positive pressure breathing apparatus at the same time. ⑴about the basic information: age, sex,smoking history, education level；⑵in hospital medical expenses, average length of stay, the times of in patient foracute exacerbation of COPD, accepting BiPAP breathing apparatus for one year；⑶the adverse events and caused complications that lead to using breathing machineby canula；⑷about ventilator dependent: we take four hour as a standard；⑸improve the quality of life；⑹the brand of BiPAP breathing machine, type, inspiratory pressure, positive endexpiratory pressure, service time；Result:1.We collect33patients totally and male to female ratio is about1.375:1, theaverage age is （64.1±9.5）of which five patients were dead；2.in hospital medical expense: the expense before accepting non-invasive positivepressure ventilation one year ago minus the expense that buying the breathing machineRMB (29800±9900)comparing with the expense after accepting non-invasive positivepressure ventilation one year later(23200±7800) RMB；3.the average length of stay(90.77±28.56) day befor and after using non-invasivepositive pressure ventilation one year(40.12±13.34)；4.the times of in patient for acute exacerbation of COPD befor(5.89±2.44)day andafter using non-invasive positive pressure ventilation one year(40.12±13.34)day；5.the compliance of patients to the breathing machine: there are24patients usingnon-invasive positive pressure ventilation six hours per day for one year；6.adverse events:19patients have occurred flatulence, accompanying withdiarrhea or not, vomiting and aspiration, nasal mask or face mask oppress bridge of thenose and facial region, mouth or pharynx dry and so on；7.the times of complications that lead to using breathing machine by canula is(1.22±1.05)to (1.01±1.00)；8.some problems that exists in BiPAP breathing apparatus, for example: the firsttime using and some advanced age patients have fighting fear, medical personnel anddealer don’t follow up regularly, some patients adjust the breathing machine parameterunintentionally and can’t deal with it, because this machine don’t have monitorfeedback system, so the patients using it long-term need do blood gas analysis；Conclusion：BiPAP reduce the times of in patient for acute exacerbation of COPD, average length of stay and in hospital medical expense. It also lengths the stationary phase ofCOPD and improve the patients quality of life. Domestic non-invasive positive pressureventilation is accepted by more and more patients along with the improvement of themedical and people’s living standards. And it has become a common therapy fortreating with acute exacerbation of COPD and should be popularized in some condition.