Study On Effects Of Navel Therapy For Nourishing And Warming Kidney-yang On Weaning From Mechanical Ventilation For COPD Patients With Respiratory Failure

BackgroundChronic obstructive pulmonary disease (COPD) is a chronic respiratory disease of high incidence, disability and mortality. Patients with COPD recur from time to time, the condition tends to persist and is hard to cure, and respiratory failure and other complications often concur. Mechanical Ventilation is an important treatment for COPD patients with respiratory failure. But a lot of these patients suffer from difficult weaning and this problem is still not solved with current recommended weaning protocol or other relevant methods.ObjectiveTo observe effects of navel therapy for nourishing and warming Kidney-yang on weaning from mechanical ventilation for COPD patients with respiratory failure, by counting success rate of weaning, measuring ventilatory parameters and the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, etc. Attempt to find a new solution to difficult weaning.MethodsThis study is a prospective randomized controlled trial. It studied 40 inpatients treating with mechanical ventilations because of respiratory failure due to acute exacerbations of COPD from Intensive Care Unit (ICU) of Guangdong Provincial Hospital of TCM from October 2008 to April 2010, these patients were randomly distributed into treatment group(20 cases, treating with navel therapy for nourishing and warming Kidney-yang, invasive mechanical ventilation and conventional drug therapy) and control group(20 cases, treating with invasive mechanical ventilation and conventional drug therapy). Multiple aspects before and after treatment were observed and recorded, such as APACHEⅡscores, heart rates, respiratory rates, ventilatory parameters, incidence of complications(VAP, deep fungal infections and upper gastrointestinal hemorrhage), success rate of weaning, mortality, the mechanical ventilation time, costs and length of hospital stay and so on.ResultsUp to April 2010,2 cases(1 in treatment group and 1 in control group) were still under observation, so these 2 cases were not included in this statistic analysis. There was no significant baseline difference between treatment group and control group. Significant improvement was detected in general physiology parameters (respiratory rates, heart rates, blood gas analysis, APACHE II scores) and ventilatory parameters(tidal volume, minute ventilation, rapid shallow breathing index and inspiration time%) in both two groups after treatment and there was significant difference in APACHE II scores (treatment group:10.68±4.92; control group:14.95±7.89), RSBI (treatment group: 54.35±9.50 bpm/L; control group:62.99±14.73 bpm/L) and Ti%(treatment group: 30.89±1.94%; control group:32.95±2.93%) between the two groups after treatment.Compared with control group, navel therapy for nourishing and warming Kidney-yang significantly increased the success rate of weaning and decreased average daily hospitalization expenses. But there was also no statistically significant difference in mechanical ventilation time, incidence of complications, costs of hospitalization, length of hospitalization and mortality during hospitalization, which might be related to sample size.ConclusionThis study indicated that navel therapy for nourishing and warming Kidney-yang might ameliorate general physical parameters and ventilatory parameters, improve respiratory muscle endurance and increase success rate of weaning, but these conclusions still need verification in further study because of the sample size of this study.