The Application Of Noninvasive Ventilator In Respiratory Failure Cases With Nasotracheal Intubation

Objective: 1.To investigate the feasibility of application of noninvasive ventilator for invasive mechanical ventilation in respiratory failure cases with nasotracheal intubation. 2.The comparision between the group of conventional invasive and non-invasive sequential mechanical ventiltaion, and the group that keeping endotracheal intubation and applying of noninvasive ventilator for invasive mechanical ventilation,and then sequential noninvasive mechanical ventilation after weaning.We observed the two groups of patients the ratio of weaning succeed, the retention time of artificial airway and noninvasive ventilator use after weaning.Methods: Choose of forty-eight respiratory failure cases with nasotracheal intubation, when pulmonary infection of the patients were controlled,autonomous respiration of them existed,but the patients cloud not wean from mechanic ventilation. Forty-eight patients were randomly divided into two groups.The group of A keeped endotracheal intubation and applied of noninvasive ventilator for invasive mechanical ventilation.The group of B continued to invasive mechanical ventilation.The two groups of patients sequential noninvasive mechanical ventilation after weaning. We observed the two groups of patients the ratio of weaning succeed, the retention time of artificial airway and noninvasive ventilator use after weaning. Record the arterial blood gases of the patients of the group of A before and after applying of noninvasive ventilator for invasive mechanical ventilation,and record the prognosis.Results: 1.The arterial blood gases of the patients of the group of A before and after applying of noninvasive ventilator for invasive mechanical ventilation have no change. 2.The ratio of weaning succeed,the retention time of artificial airway have no statistical differences,but the time of noninvasive ventilator use after weaning had significant statistical differences.22 of the 24 patients of the group of A were pull out the endotracheal intubation, the ratio of weaning succeed is 91.7%. 21 of the 24 patients of the group of B were pull out the endotracheal intubation, the ratio of weaning succeed is 87.5%, there was no statistical significance.Retention time of artificial airway of the patients of the group of A were 7.79±1.14 days,and that of the patients of the group of B were 7.67±1.93 days, there was no statistical significance.The time of noninvasive ventilator used after weaning of the patients of the group of A were 4.68±1.64 days,and that of the patients of the group of B were 6.45±2.61 days.This aspect is significant statistical differences.Conclusion: 1.Application of noninvasive ventilator for invasive mechanical ventilation in respiratory failure cases with nasotracheal intubation is feasible. 2.Compared with the group of conventional invasive and noninvasive sequential mechanical ventilation,respiratory failure cases with nasotracheal intubation keeped endotracheal intubation and applied of noninvasive ventilator for invasive mechanical ventilation,and then sequential noninvasive mechanical ventilation after weaning,the ratio of weaning succeed and retention time of artificial airway have no statistical differences,but the time of noninvasive ventilator use after weaning can be shortened.