Mechanical Ventilation In Patients With Heart Failure In The Early Application Of Clinical Research

ObjectiveThrough the research of Heart Failure(Heart Failure) before and after mechanical ventilation in patients with clinical symptoms, Heart rate, blood pressure, blood oxygen saturation(SPO2), blood gas analysis and Heart function changes and the prognosis of patients, and compared with the control group, in order to investigate the early feasibility and efficacy of mechanical ventilation in patients with Heart Failure, for early clinical application of mechanical ventilation in China based on evidence-based medicine.MethodsChoice in April 2013- March 2014 hospital of 32 patients with heart failure were admitted in the emergency department and ICU for mechanical ventilation group(treatment group), and 2013 years ago in the hospital emergency department and ICU patients as control group 30 cases of heart failure.(1) mechanical ventilation group(treatment group) : 32 cases of male 22 cases, 10 cases of female, aged 69±8 years old, the primary basis of disease of 20 patients with coronary heart disease among 12 cases of acute myocardial infarction(ami), 6 cases of hypertensive heart disease, cardiomyopathy in 5 cases, 1 cases with rheumatic heart disease, all patients for cardiac function Killip Ⅱ magnitude, Ⅳ heart function class(NYHA classification), ecg monitoring is administered after hospitalization, blood pressure, blood oxygen saturation continuously monitor, such as in conventional diuretic, cardiac, vasodilator reconciliation convulsion to smooth wheezing(such as treatment, on the basis of noninvasive ventilation treatment.(2) in the control group: 30 cases and in 2013 in our hospital emergency department and ICU inpatients, in line with the diagnostic criteria for acute left heart failure, the male 20 cases, 10 cases of female, aged 70±9 years old, the primary basis of disease for 19 cases of coronary heart disease, including 11 cases of acute myocardial infarction(ami), 8 cases hypertensive heart disease, cardiomyopathy, 2 cases, 1 case of rheumatic heart disease. All patients for cardiac function Killip Ⅱ magnitude, Ⅳ heart function class(NYHA classification), routinely giving high-concentration oxygen(oxygen flow 5 ~ 10 L/min), diuresis, cardiac, antispasmodic treatment to smooth wheezing(such as vasodilator settlement. Comparing the indicators before and after treatment in both groups have statistically significant.Results1. Control group and treatment group before treatment in patients with heart rate, breathing, blood pressure, arterial oxygen partial pressure, oxygenation index, blood oxygen saturation, the degree of clinical acute heart failure bed grading monitoring indexes such as comprehensive evaluation group differences had no statistical significance(P > 0.05);2. Control group and treatment group after treatment, clinical symptoms, the two groups after treatment than before treatment in patients with acute heart failure clinical degree bedside grading were decreased significantly(P < 0.05), and the more significant the treatment group than the control group,( P < 0.05);3. Compared to the control group and treatment group, treatment group in heart rate, breathing, arterial oxygen partial pressure, oxygenation index, improvement of blood oxygen saturation and respiratory difficulties, monitoring indicators were significantly better than the control group, the difference was statistically significant(P < 0.05); The two groups after treatment of mean arterial pressure(MAP) was significantly decreased, the but the curative effect of two groups there was no statistically significant difference(P > 0.05);4. The control group and treatment group patients before treatment of cardiac biomarkers monitoring index of serum N terminal pro-brain natriuretic peptide(NT-pro BNP), cardiac troponin I(c Tn I) assess group differences had no statistical significance(P > 0.05); 24 and 48 h after treatment in both groups NT- pro BNP are lower, but the reduction treatment group than the control group, two groups compare the difference was statistically significant(P < 0.05); And two groups of patients with myocardial infarction in patients with the increasing level of c Tn I, but rise in treatment group is lower than the control group, two groups compare the difference was statistically significant(P < 0.05).Conclusion1. The heart failure patients with mechanical ventilation can effectively slow down the heart rate, lower blood pressure, improve arterial blood oxygen partial pressure and oxygenation index, improve blood oxygen saturation, relieve dyspnea, significantly improve the symptoms of heart failure in patients with pulmonary edema. In other words, the mechanical ventilation applied in hf patients can effectively improve disease.2. Heart failure patients with mechanical ventilation to reduce serum N terminal pro-brain natriuretic peptide and troponin I level, which can effectively improve the patients with heart failure, especially the prognosis of patients with acute myocardial infarction complicating heart failure.