Time Effect Of Heliox In The Early Stage Of Invasive Mechanical Ventilation For Patients With AECOPD

ObjectivesTo study the time effect of heliox in the early stage of invasive mechanical ventilation for patients with acute exacerbation of chronic obstructive pulmonary disease.MethodsThis study chosen 41 patients into treatment group,those were been treated with invasive mechanical ventilation with heliox in ICU of our Hospital from November2016 to February 2019.There are 28 males and 13 females,age is 46⁷5 years old,with the mean±standard:62.3±4.7 years old;the course of a disease is 2¹4 years,with the mean±standard:7.26±1.47 years;BMI is 17.8²3.4,with the mean±standard:19.4±1.25;taking APACHEⅡscore in the first 24 hours,the score is 23³6 points,with the mean±standard:24.9±2.17 points.As the same time,38 patients without inhaling the heliox were chosen for control group.There are 26 males and 12 females,age is 45⁷9years old,with the mean±standard:60.4±5.1 years old;the course of a disease is 3¹2years,with the mean±standard:6.95±1.64 years;BMI is 17.4²4.3,with the mean±standard:20.9±1.37;taking APACHEⅡscore in the first 24 hours,the score is 21³7points,with the mean±standard:23.5±1.98 points.Mechanical ventilation were given successively during treatment.The parameters before and after inhaling heliox were collected in the patients when they were receiving the therapy by the mechanical ventilation at the early stage.The parameters include vital signs index（temperature,heart rate,respiration rate）,the arterial blood gas index（PH,PaCO₂,PaO₂）,respiratory dynami-cs index（inspiratory resistance,expiratory resistance,Ppeak,Ppause,PEEPi,dynamic lung compliance,work of breathing）.The parameters collected at the beginning of mechanical ventilation were marked T₀.Theparameters collected at the time when 30minutes after start point were marked T₀’.After T₀’,we replaced air-oxygen mixture with heliox.Now Start the clock,the parameters at 30 minutes were marked T₃₀,the parame-ters at 60 minutes were marked T₆₀.And so on,the parameters were markedT₉₀,T_120。During the treatment,the mechanical ventilation with the air-oxygen mixture were given to the control group consecutively.All datas were analyzed with professional statistical software,mean±standard deviation shows count data,two independent-samples LSD-t test shows parameter,α=0.05 as the inspection level,and P<0.05 means the difference is statistically significant.ResultsResearch shows that most parameters have changed after the beginning of mechanical ventilation with air-oxygen mixture.The parameters in treatment group showed that since we replaced air-oxygen mixture with heliox,the changes were more evident.The study showed that PaCO₂,inspiratory resistance,expiratory resistance,PEEPi,Ppeak,Ppause,WOB descended after shifting.On the contrary,PaO_2,dynamic lung compliance increased.The changes showed significant difference after shifting to heliox,and the difference between T₀’and T_30,T₃₀0 and T₆₀0 were statistically signifi-cant（P<0.05）.The significant changes appeared in 60 minutes after shifting.The difference between T₆₀0 and T_90,T₉₀0 and T₁₂₀20 did not show significant statistical differen-ce（P>0.05）.The numerical values of heart rate and respiration rate returned to normal or almost normal.The differences between the parameters at T₀ and T₀’,T₀’and T₃₀0 were significant（P<0.05）.But the difference between T₃₀0 and T₆₀,T₆₀0 and T₉₀,T₉₀0 and T₁₂₀20 did not show significant statistical difference（P>0.05）.And the numerical values of temperature did not change evidently during the mechanical ventilation with air-oxygen mixture and heliox.There were not show hypothermia.ConclusionThis research found that inhaling heliox in the early stage of invasive mechanical ventilation for patients with AECOPD can reduce PaCO₂,inspiratory resistance,expiratory resistance,PEEPi,Ppeak,Ppause,increase WOB and PaO₂ and dyamic lung compliance.Those changes can improve breathing status significantly,relie-ve fatigue of respiratory muscles,appeared promptly after shifting,and maintained stability after 60 minutes.After 60 minutes,the new changes never appeared.Therefore,it is concluded that invasive mechanical ventilation should be treated with helium-oxygen mixture,which can effectively and rapidly improve patients’respiratory dysfunction,correct carbon dioxide retention,reduce airway pressure and respiratory work,improve chest and lung compliance,and promote patients’recovery.Figure 1;Table 7;Reference 69...