| Objective:Electrical impedance tomography(EIT)technology was used to monitor the level of pendelluft to evaluate the effectiveness of non-invasive mechanical ventilation therapy in patients with acute respiratory failure,and whether it can be used as an index to evaluate the effectiveness of non-invasive mechanical ventilation,in order to quickly identify high-risk patients with non-invasive mechanical ventilation and improve clinical efficacy.Method:Our study is a prospective and observational study,it was included patients with non-invasive mechanical ventilation(37 cases)admitted to the Intensive Care Unit of the First Affiliated Hospital of Nanchang University from December 2021 to March 2023.Patients were divided into successful NIV group(11 cases)and failed NIV group(26 cases)according to clinical transition.Clinical data such as gender,age,BMI,primary disease,and blood gas analysis were collected,and the patients’pendelluft was monitored by the EIT technique within the first 24 hours of receiving non-invasive mechanical ventilation treatment.SPSS23.0 was used to compare the differences in baseline data,pendelluft and FiO2/PaO2 between the two groups,and the ROC curve was used to compare the difference in the evaluate ability of pendelluft and FiO2/PaO2 on the effect of NIV.Outcome:(1)There were no significant differences between age,sex,BMI,APACHE II score,SOFA score,respiratory rate,heart rate,MAP,PH,oxygen partial pressure and carbon dioxide partial pressure between the successful and failed noninvasive mechanical ventilation group(P>0.05).(2)Compared with the failed NIV group,the pendelluft of successful NIV group was higher(P<0.05),and the ROC curve showed that the AUC of pendelluft amplitude,inspiratory phase time and expiratory phase time to predict noninvasive mechanical ventilation failure were 0.815,0.799 and 0.774,and the Cut-off values were 45.1124,0.475s and 0.075s.The sensitivity and specificity of the pendelluft amplitude were 72.7%and 92.3%.(3)Compared with the failed NIV group,the successful NIV group FiO2/PaO2 was higher(P<0.05),and the AUC predicted by the FiO2/PaO2 of failed NIV group was 0.787,the Cut-off value was 153mmHg,and the sensitivity and specificity were 90.9%and 57.7%.Pendelluft evaluates noninvasive mechanical ventilation effect with greater accuracy and specificity than FiO2/PaO2.Conclusion:The application of EIT to monitor the pendelluft in patients can evaluate the effect of noninvasive ventilation,and the accuracy and specificity of pendelluft in evaluating effect of noninvasive mechanical ventilation are higher than that of FiO2/PaO2.Pendelluft is an innovative and valuable indicator for immediate bedside monitoring,feasible and reproducible,and has important clinical significance for early identification of high-risk patients with non-invasive mechanical ventilation failure and to reduce the rate of delayed endotracheal intubation. |
