To Investigate The Effect Of Noninvasive Ventilation In Prevention Of Severe Hand Foot And Mouth Disease And Neurogenic Pulmonary Edema

Objective:To Investigate the clinical effects of noninvasive ventilation in neurogenic pulmonary edema and Hand severe foot and mouth disease.Methods:78 childrens of severe hand, foot and mouth disease(3)patients in PICU of Jiangxi children’s hospital from May 2010 to May 2014 were divided into noninvasive ventilation group(38) and invasive ventilation group(40) randomly.Duration of hospital stays, progress of disease, duration of startle, heart rate, blood pressure, blood gas, C-reaction protein, white blood cell, neurogenic pulmonary edema and prognosis influenced by two different ventilation models were analyzed.Results:1. PH of noninvasive ventilation and invasive ventilation groups were(7.43±0.48)and(7.39±0.98)respectively,Pa O2,Pa CO2,BE of these groups were(168.6±77.9)mm Hg、(180.4±94.4)mm Hg,(30.0±6.3)mm Hg、(32.3±6.7)mm Hg,(-3.8±3.2)and(-4.8±4.6)respectively. the difference between noninvasive ventilation and invasive ventilation group was not showed.2. Compared with noninvasive ventilation group, the difference of the WBC and LAC in invasive ventilation group was not showed. The data were(12.1±4.5)x109.L-1、(14.4±6.4)x109.L-1and(1.8±1.3)mg/L、(1.9±2.2)mg/L.the difference of blood glucose in noninvasive ventilation group(7.4±2.2)mmol/L and invasive ventilation group(9.8±4.1)mmol/L were observed.3. Compared with noninvasive ventilation group,the difference of heart rate and blood pressure in invasive ventilation group was not showed. The data were(146.7±14.5)beats/min and(153.1±21.4)beats/min,(110.2±7.8)/(66.7±8.2)mm Hg and(108.1±13.1)/(64.7±12.5)mm Hg.4. The disease course in invasive ventilation group(2.3±1.8)days was shorter than noninvasive ventilation group(4.5±1.8)days. Duration of fever in invasiveventilation group and noninvasive ventilation group were( 1.6±1.6) days and(2.0±1.5)days,Duration of hospital stays and duration of startle in invasive ventilation group and noninvasive ventilation group were( 5.5±2.4) days and(6.1±5.9)days,(1.8±0.8)days and(1.5±1.1)days respectively. The difference of these data were not showed.5. No cases of neurogenic pulmonary edema in the noninvasive ventilation group, 8 cases of neurogenic pulmonary edema in the invasive ventilation group,which has significant differences(P<0.05);No cases of noninvasive ventilation group progress to stage 4,8 cases of invasive ventilation group progress to stage 4,which has significant differences( P<0.05); 6 cases were cured of the noninvasive ventilation group,7 cases were cured of the invasive ventilation group,which was no significant differences(P>0.05).32 cases improved of the noninvasive ventilation group,23 cases improved of the invasive ventilation group,which has significant differences( P<0.05).No cases deaths of the noninvasive ventilation group, 5cases deaths of the invasive ventilation group, which has significant differences(P<0.05).Conclusion:Noninvasive mechanical ventilation has advantage in preventing the progression of severe hand, foot and mouth disease(3),neurogenic pulmonary edema,reducing of invasive mechanical ventilation.