Early Application Of Bi-level Positive Airway Pressure Non-invasive Ventilation In The Treatment Of Acute Cardiogenic Pulmonary Edema Evaluation Of Effect

Objective:In this study,we compared the effective rate of two different respiratory support methods of bi-level airway positive pressure non-invasive ventilation and nasal catheter oxygen inhalation in patients with acute cardiogenic pulmonary edema,reflecting the improvement of respiratory function and cardiac function,and so on.The subject of this study was to explore the effectiveness and clinical value of respiratory and cardiac function in Patients with acute cardiogenic pulmonary edema after bi-level airway positive pressure non-invasive ventilation treatment.Methods:The clinical data of 51 patients with acute cardiogenic pulmonary edema treated in the emergency department of Liaoning Provincial People’s Hospital from November 2018 to January 2021 were summarized and analyzed retrospectively.According to the different modes of respiratory support used during treatment,the patients were divided into two groups:Ventilation group（n=25）and Nasal catheter group（n=26）.The vital signs of the two groups were monitored after entering the emergency room.The patients in the nasal catheterization group were given oxygen inhalation support from nasal catheters while the patients were treated with anti-heart failure drugs.The patients in the ventilation group were treated with bi-level positive airway pressure mode.The remission time of clinical symptoms and signs after active anti-heart failure and respiratory support treatment was compared between the two groups;the vital sign related indexes,arterial blood gas analysis and NT-pro BNP were compared between the two groups before treatment（T1）and 12 hours after treatment（T2）;LVEF was compared between the two groups before treatment（T1）and 48 hours after treatment（T3）.And the clinical treatment efficiency of the two groups was compared.Results:There was no marked difference in clinical data before treatment between two groups（P>0.05）.After treatment with anti-heart failure drugs and respiratory support,the remission time of clinical symptoms and signs in ventilation grou Pp[20（16.50-25.00）minutes]was significantly shorter than that in oxygen inhalation group[52（33.00-87.25）minutes]（Utility 27 minutes P<0.05）.After active treatment,the related indexes of all the subjects of study were obviously improved,such as the heart rate,respiratory rate and mean arterial blood pressure at T2 in the ventilation group were lower than those in the oxygen inhalation group,while the SPO₂was obviously higher in the ventilation group than in the oxygen inhalation group.The degree of improvement of PaO₂ and Oxygenation index at T2 in the ventilation group was better than that in the oxygen inhalation group,on the contrary,PaCO₂was lower.The degree of improvement of NT-pro BNP and cTnI at T2 in the ventilation group was better than that in the oxygen inhalation group,and the LVEF value at T3 in the ventilation group was obviously higher than that in the nasal catheter group（P<0.05）.After treatment,the results showed that in the ventilation group,there were 18 effective cases,6 effective cases,1 neffective case,24 total effective cases,and the total effective rate was 96%.In the other group,there were 5 effective cases,12 effective cases,9 ineffective cases,17 total ffective cases,and the total effective rate was 65.4%.The total effective rate of the entilation group was significantly higher than that of the oxygen inhalation group（P<0.05）.Conclusion:The outcome of the study suggest that bi-level airway positive pressure ventilation has a definite clinical effect on patients with acute cardiogenic pulmonary dema,and can quickly and effectively improve the related symptoms of respiratory and cardiac dysfunction caused by tissue hypoxia in such patients.Its clinical practical value has been affirmed,so it is highly recommended that patients with acute cardiogenic ulmonary edema,should be treated with bi-level airway positive pressure ventilation as soon as possible.