Safety And Effectiveness Of Different Inspired Oxygen Concentration In Treatment Of AECOPD Patients With Type Ⅱ Respiratory Failure Under The Condition Of Non-invasive Ventilation

Objective:Research AECOPD patients with type Ⅱ respiratory failure by non-invasive positive pressure ventilation (NIPPV) with different oxygen concentration on arterial blood gas and markers of myocardial damage results to evaluate the safety and efficacy of different oxygen concentrations to explore. In the end of to explore the best choose of density of oxygen.Methods:Randomly selected from June 2014-January 2016 AECOPD admitted in our Department with type Ⅱ respiratory failure of 80 patients.53 cases of males, and 27 cases of women, aged 54-89 years. According to the inspired oxygen concentration were randomly divided into 4 groups:group A (FiO2 25%), group B (FiO2 35%), group C (FiO2 45%), group D (FiO2 55%),20 patients in each group. Compare of the changes of blood gas analysis、PH、PO2、PCO2 were observed in the four groups before and after in use of non-invasive ventilation (NIPPV) in 2H, Id,3d,5d,7d in the same time. Compare of the changes of CK-MB、cTnI were observed in the four groups before and after in use of non-invasive ventilation (NIPPV) in Id,3d,5d,7d in the same time. To monitor respiration, Pulse, blood oxygen saturation, and breathing difficulty scoring.Results:(1)Non-invasive mechanical ventilation in different inspired oxygen concentrations under four groups of blood gas analysis:PH results over time tend to be stable; the set PaO2 extended upward trend over time. Among 7d groups overall results significantly higher PaO2, has significantly improved compared with before treatment, In group A,B,C, there are significant differences between groups, no significant differences between group C and D.45% oxygen concentration PaO2 was significantly higher, and with 55% no difference in oxygen concentration.PaO2 increased significantly compared with before treatment. PCO2 is significantly lower than before treatment, and with the longest treatment time, partial pressure of carbon dioxide decreases. With no obvious carbon dioxide retention of aggravating circumstances. After treatment 5d,7d group B、C and D, there was a statistically significant difference (P <0.05), and Group C and Group D had unified statistical significance(P>0.05).45% oxygen concentrations compared with the low oxygen concentration PaCO2 decreased significantly, and 55% no difference in PaCO2 decreased oxygen concentrations Arterial blood gas analysis results in the overall group compared with before treatment are becoming more stable.(2)Non-invasive mechanical ventilation under different oxygen concentrations, four groups of myocardial injury markers in patients with troponin Ⅰ and CK-MB are declining. Improve significantly after the treatment in patients with 3D,3D point overall there were statistical differences between the groups, P<0.05. The rest no statistical difference between the groups overall, p>0.05. Compared at different points within the same group, four sets of changes of myocardial injury markers in patients with decreased.Conclusion:(1)Acute exacerbation of chronic obstructive pulmonary (AECOPD) with type Ⅱ respiratory failure in patients with non-invasive mechanical ventilation in the proper control of inspired oxygen concentration, and FiO245% for improving hypoxia and hypercapnia in patients with improvement in both, and does not cause carbon dioxide retention.(2)Timeoxygen time prolonged, AECOPD hypoxia in patients with improvement in arterial blood gas analysis of stabilized after treatment of myocardial injury markers in 3D improved significantly.(3)AECOPD type Ⅱ respiratory failure in patients with non-invasive mechanical ventilation in patients with 45% of the oxygen concentration, improved in patients with hypoxia, oxygen important organizations, while ensuring that the safety.