Objective To investigate the effectiveness of noninvasive positive pressure ventilation( NPPV) in acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) complicated with severe type Ⅱ respiratory failure.Methods 37 patients who were admitted fromJanuary 2008 to June 2009 due to AECOPD complicated with severe type Ⅱ respiratory failure and had received NPPV therapy were enrolled as a NPPV group. Another similar 42 cases who had not received NPPV therapy served as control. All subjects received standard medication therapy according to the guideline. Arterial blood gases before and after treatment, the duration of hospitalization and intubation rate were observed. Results The arterial pH, PaO2 ,and PaCO2 improved significantly after treatment as compared with baseline in both groups ( P lt; 0. 05) .Compared with the control group, the average duration of hospitalization was significantly shorter ( 10 ±5 vs.19 ±4 days, P lt;0. 05) and the intubation rate was significantly lower ( 2. 7% vs. 16. 7% , P lt;0. 05) in the NPPV group. Conclusion The use of NPPV in AECOPD patients complicated with severe type Ⅱ respiratory failure is effective in improving arterial blood gases, reducing the duration of hospitalization and intubation rate.
Citation：
ZHI Rongchang,LIU Xiaoyan,LIU Zhitao,CHEN Wanhua. Panyu Peoples Hospital.. Effectiveness of Noninvasive Positive Pressure Ventilation in Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Severe Type Ⅱ Respiratory Failure. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(4): 353-355. doi:
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孔维民, 王辰, 杨媛华, 等. 外源性呼气末正压对慢性阻塞性肺疾病患者呼吸功的影响. 中华内科杂志, 2001 , 40: 385-389.
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- 1. Global Initiative for Chronic Obstructive Lung Disease. Globalstrategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease-updated 2009. Bethesda: National Institutes of Health, National Heart, Lung, and Blood Institute;2009. Available from: www. goldcopd. com/ revised. pdf.
- 2. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南( 2007 年修订版) . 中华结核和呼吸杂志,2007, 30: 8-17.
- 3. 苏莉莉. 慢性阻塞性肺部疾病呼吸肌疲劳的发病机制. 国外医学( 呼吸系统分册) , 2000, 20: 27 -29 .
- 4. 植荣昌, 梁结柱, 刘知陶, 等. 无创正压通气治疗慢性阻塞性肺疾病急性加重期并Ⅱ 型呼吸衰竭临床分析. 中国实用内科杂志, 2007, 27: 358-359 .
- 5. 植荣昌, 吴文斌, 郭健, 等. 无创面罩( 鼻) 通气治疗慢性阻塞性肺疾病的临床疗效观察——— 附47 例报告. 新医学, 2002 , 33 :147-150.
- 6. Antonelli M, Pennisi MA, Montini L. Clinical review: noninvasive ventilation in the clinical setting experience fromthe past 10 years.Crit Care, 2005 , 9: 98-103.
- 7. Robriquet L, Georges H, Leroy O, et al. Predictors of extubation failure in patients with chronic obstructive pulmonary disease. J Crit Care, 2006, 21: 185-190 .
- 8. Delay JM, Sebbane M, Jung B, et al. The effectiveness of noninvasive positive pressure ventilation to enhance preoxygenation in morbidly obese patients: a randomized controlled study. Anesth Analg, 2008 , 107: 1707-1713.
- 9. 孔维民, 王辰, 杨媛华, 等. 外源性呼气末正压对慢性阻塞性肺疾病患者呼吸功的影响. 中华内科杂志, 2001 , 40: 385-389.
- 10. Brochard L, Mancebo J, Elliott MW. Noninvasive ventilation for acute respiratory failure. Eur Respir J, 2002, 19: 712-721.
