The Impact Of Noninvasive Positive Pressure Ventilation Different Pressure Support Level On Intra-abdominal Pressure For AECOPD

Objective:Through monitoring the level of intra-abdominal pressure, airway pressure, hemodynamic parameters,blood gas analysis in patients with noninvasive positive pressure ventilation in AECOPD, to compare thelevel of pressure support with AECOPD patients, and to explore the clinical significance forintra-abdominal pressure changes in different pressure support. Provide a theoretical basis for AECOPDpatients with noninvasive mechanical ventilation select appropriate pressure support level, and providereference for detection abdominal distension and aspiration for clinical mechanically ventilated patients inthe early.Method:60noninvasive positive pressure ventilation patients, in accordance with the level of positive pressureventilation pressure support divided them into three groups randomly:10-14cm H2O (Group A),15-19cmH2O (Group B),20-25cm H2O(Group C), every group have20patients. Respectively, monitoring theintra-abdominal pressure prior to the mechanical ventilation, and after adjust pressure support level twohours, from the first day to the seven days, on the first, three, five, seven days at the same time pointmonitoring the airway pressure, hemodynamic and blood gas analysis. Repeated measurement data usingSPSS17.0statistical software for statistical analysis, all measurement data are presented as mean±standarddeviation (x S) under different pressure support level compared using repeated measures ANOVA.Results:After noninvasive positive pressure mechanical ventilation, compared with IAP of three groups wasstatistically significant (P<0.05) in difference pressure support level, in which intra-abdominal pressure ingroup C with the other two groups the differences were statistically significant (P<0.05). Compared groupA and group B the difference was not statistically significant (P>0.05). After mechanical ventilation thelevel of intra-abdominal pressure have tended to increased, compared with prior ventilation, and thedifferences were statistically significant (P<0.05). Group B compared with group A and B, the peak airwaypressure in group C was statistically significant (P<0.05). Compared with Group A and B, the differencewas not statistically significant (P>0.05).Compared with group C, mean airway pressure and platformpressure differences in group A and group B were statistically significant (P<0.05), the other two grouphave no statistically significant difference (P>0.05). The mean arterial pressure and heart rate in threegroups have no statistically significant (P>0.05), but with the pressure support levels increased centralvenous pressure have increased, the intra-abdominal pressure have increased too, they are positivelycorrelated (r=0.899, P=0.000<0.05).Conclusion:1With the level of pressure support increased, the intra-abdominal pressure of AECOPD patients withnoninvasive mechanical ventilation increased, and compared with intra-abdominal pressure beforemechanical ventilation had elevated trend, so non-invasive mechanical ventilation can cause intra-abdominal pressure rise.2For AECOPD patients in noninvasive mechanical ventilation, with elevated levels of pressure support,intra-abdominal pressure, central venous pressure and airway pressure levels were increased, theyinfluenced each other, and more obviously in the early mechanical ventilation. Provide references fornoninvasive mechanical ventilation in patients with AECOPD to select suitable pressure support level.3In order to avoid the influence of airway pressure and hemodynamic caused by increasedintra-abdominal pressure, noninvasive mechanical ventilation patients should promote early detection ofintra-abdominal pressure.