Effects Of Non-invasive Positive Pressure Ventilation On COPD Patients With Type-â…¡Respiratory Failure

Objective: To evaluate the efficacy of non-invasive positive pressure ventilation in COPD patients with type-â…¡respiratory failure, and get some experience to guide clinic practice. Methods: 40 cases of COPD patients with type-â…¡respiratory failure were retrospectively analysed.Based on conventional medical therapy,all the cases received non-invasive bi-level positive airway pressure ventilation.The changes of symptoms,Arterial blood gas analyses,respiratory rate,heart rate and blood pressure were observed before and after treatment,then the comparisons of these results were made. Results: In the 40 cases,these were 32 cases acquired obvious symptomatic improvement (higher level of consciousness,respiratory rate stepped down,dyspnea lessened) and got discharge;the other 8 cases deteriorated(5 died,2 discharged automatically,1 received tracheal intubation for invasive ventilation).the total efficacy rate was 80%.for these patients,The respiratory rate before and after ventilation were(24±4)/min and(20±4)/min,the heart rate were(110±17 ) /min and ( 91 ±22 ) /min respectively.there were significant difference in both,P<0.05.However,blood pressure of these patients before and after ventilation were(124±17)/(75 ±11)mmHg and(120 ±17)/(72±9)mmHg,there was no significant difference,P>0.05.The patients'PaCO₂ before and after the ventilation were(76±20)mmHg and(63±17)mmHg respectively,there was a significant difference, P<0.05. The PaO2 before and after ventioation for those 26 patients whose PaO2>60mmHg after received conventional medical therapy were(81±24)mmHg and (74±20)mmHg respectively,and for those 14 patients whose PaO2<60mmHg after received conventional medical therapy were(44±11)mmHg and (64±19)mmHg respectively.The difference was obvious in the latter, P<0.05 , but not in the former,P>0.05.During ventilation treatment, the ventilation associated complications included gastric distention occurred in 5 patients, dry mouth in 7 patients, poor tolerated in 2 patients, ventilator-depending in 2 patients. none of 40 patients suffered barotraumas, hospital acquired infection or ventilation associated pneumonia and so on . Conclusions: The application of non-invasive BiPAP ventilation in COPD patients with type-â…¡respiratory failure could improve symptoms and the blood gas indices,stabilize vital sign,and has less complications,which demonstrate that non-invasive BiPAP ventilation is an effective,well tolerated and safe,convenient approach for those patients and plays a leading role in clinic practice.