The Efficacy Of Household Noninvasive Positive Pressure Ventilation In Patients With Chronic Left Heart Failure

Objective: Chronic left heart failure(CHF)is a complex clinical syndrome and the serious stage of various heart disease,which is characterized by high morbidity and high mortality.People are continuously seeking an effective approach of prevention and cure of chronic left heart failure.With the continuous deepening of clinical practice,it can effectively reduce the process of chronic left heart failure and improve the survival rate from simple to improve hemodynamics to adersely affect nerve-endocrine hormone treatment.In recent years,domestic and foreign scholars have opened up non-drug treatment of chronic left heart failure test and clinical research.Based on the concept of interaction and mutual influence of respiratory system and circulatory system,the use of household noninvasive ventilation as one of the treatment of chronic left heart failure has been paid more and more attention.The purpose of this study was to investigate household noninvasive positive pressure ventilation in chronic therapy effect of left heart failure,in order to excavate the new use of noninvasive ventilation and provide more reliable and convenient method for the family treatment in patients with chronic left heart failure,so as to extend the patients survival time and improve the patients quality of life.Methods:1 We selected 31 cases with chronic left heart failure who were admitted to our hospital from January 2016 to December 2016.It included 18 men and 13 women aged from 61 to 75,an average of 69.37 years old.All patients were eligible for the diagnosis of chronic left heart failure.All patients were assigned grade III-IV according to the New York Heart Association(NYHA)criteria,and the patients volunteered to participate in the study.Exclusion cases who can not be used correctly noninvasive ventilator treatment after the training and facial surgery trauma or deformity can not be satisfied with wearing a nose mask.Exclusion of severe hypertension,glaucoma,flatulence,can not be non-invasive ventilator,except for right heart failure and whole heart failure.2 Divided the patients into control group and treatment group.The control group was given regular anti-heart failure medication.The treatment group was treated with noninvasive positive pressure ventilation on the basis of routine drug therapy,and was treated with bilevel positive airway pressure ventilation(BiPAP).Parameter setting:S/T model,initial EPAP 4cmH20(1cmH20 =0.098 Kpa,gradually added to 4-8cmH20,initial IPAP 8cmH20,and then increase the level of each 2cmH20(shortest interval 5-10min),to the patients' clinical symptoms improved.The oxygen flow rate was adjusted according to the patient's peripheral blood oxygen saturation,in order to maintain Sp02 fluctuation above 90%.The patient is required to apply the NPPV intermittently for a duration of about 2h.Try to ensure that the patient is eating,talking,etc.Depending on the patient's condition and the tolerance of the respirator,the specific application time of each patient was determined,but the total treatment time for the daily application of the respirator should be greater than 8h.According to the patient's condition and the use of breathing machine,occasional phone calls or follow-up visits to the general situation of patients and the use of ventilators in the course of the problem,to ensure the stability of patients and the normal use of ventilators.3 Patients in the hospital,intubation or death when the watch will be terminated.4 Observation of clinical symptoms,blood oxygen partial pressure,6 minutes walk test,the level of brain natriuretic peptide and left ventricular ejection fraction after 1 year treatment.5 SPSS13.0 software package was used for statistical analysis.The measurement data is expressed as x ±s.T test was used before and after treatment.P <0.05 was considered statistically significant difference.Results:1 The treatment group of 15 patients with the completion of HNPPV treatment,noninvasive ventilation is well tolerated,good compliance.After 1 year treatment:PaO2,control group 56.32 ± 3.75 mmHg,treatment group 69.52 ± 2.71 mmHg,significantly higher than the control group,the difference between the two groups was statistically significant(P<0.05);6MWT,control group 243.42±50.13 m,treatment group 302.72±60.23 m,significantly increased compared with the control group,the difference between the two groups was statistically significant(P<0.05);BNP,control group 421.42±30.78pg/mL,treatment group 235.72±28.52pg/mL,decreased signific-antly compared with the control group,the difference between the two groups was statistically significant(P<0.05);Left ventricular ejection fraction,control group 40.25± 9.79%,treatment group 48.89±10.11%,higher than the control group obviously,the difference between the two groups was statistically significant(P< 0.05).2 During treatment the treatment group none of the patients lost to follow-up and the control group 1 lost to follow-up which lost to the reason for death.Therefore,in addition to contraindications,the application of family noninvasive ventilation can improve the heart function of patients with chronic left heart failure,which is a simple,fast,safe and effective treatment.Conclusions:Long-term household noninvasive pressure ventilation therapy can improve the patient's clinical symptoms,PaO2,6MWT,BNP,LVEF,and improve their cardiac function.