Clinical Application Value Of BiPAP Ventilator In Emergency Treatment Of Patients With Acute Heart Failure

Objective:The purpose of this study was to investigate the clinical efficacy and prognosis of two different interventions in adult patients with acute heart failure.The first intervention was bi-level positive airway pressure(BiPAP)ventilation combined with standard medical care,and the other one was conventional oxygen therapy combined with standard medical care.By comparing the different results of these two methods,to explore the efficacy,safety and clinical application value of BiPAP ventilator for acute heart failure.Methods:We retrospectively collected patients diagnosed with acute heart failure and hypoxemia in the emergency department of Jining first people’s hospital from February 1,2020 to February 1,2022.Patients were divided into observation group and control group according to different oxygen delivery methods.The observation group was treated with standard medical care and BiPAP ventilation,and the control group was treated with standard medical care and nasal catheter oxygen inhalation.After 24 hours of treatment,vital signs,include systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),respiratory rate(RR)between the two groups were compared.Meanwhile,blood gas indicators,include arterial carbondioxide partial pressure(Pa CO2),arterial partial pressure of oxygen(Pa O2),blood oxygen saturation(Sp O2),oxygenation index(Pa O2/Fi O2),lactic acid(Lac),PH were also analyzed.We also analyzed myocardial injury markers indicators,include cardiac troponin I(CTn I),myoglobin(MYO),creatine kinase-Mb(CK-MB),brain natriuretic peptide(BNP),brain natural peptide aminoterminal precursorprotein(NTPro-BNP),d-dimer(D-D).After different treatments,we compared the changes of cardiac function,dyspnea relief time,tracheal intubation rate,ICU stay time,survival rate,mortality rate,and adverse reactions between two groups.Results:The study enrolled a total of 123 patients,including 59 in the observation group and 64 in the control group.There were no differences in general data between the observation group and the control group(P>0.05).After 24 hours of treatment,the HR(t=-30.53,P<0.05),RR(t=-9.86,P<0.05),Pa O2(t=4.65,P<0.05),Pa CO2(t=-3.11,P<0.05),Sp O2(t=3.35,P<0.05),NTPro-BNP(t=-2.17,P=0.03)improved more significantly in the observation group,the difference between the two groups was statistically significant(P<0.05).The SBP(t=-0.79,P=0.43),DBP(t=-1.86,P=0.06),Pa O2/Fi O2(t=0.62,P=0.54),LAC(t=-1.56,P=0.25),PH(t=1.23,P=0.22),c Tn I(t=-1.22,P=0.22),MYO(t=0.45,P=0.65),CK-MB(t=-1.94,P=0.06),BNP(t=-1.21,P=0.23),D-D(t=-0.85,P=0.40)were improved in both groups.However,the differences between the two groups were not statistically significant(P>0.05).The relief time of dyspnea in the observation group was shorter than that in the control group(t=-6.03,P<0.05).The rate of tracheal intubation in the observation group was lower than that in the control group(~2=4.46,P<0.05),and the difference was statistically significant.The incidence of abdominal distension in the observation group was higher than that in the control group(~2=6.05,P=0.01).There was no obvious difference in other adverse reactions such as vomiting(~2=0.03,P=0.85),accidental choke(~2=0.22,P=0.64),dry mouth and nose(~2=1.97,P=0.16)between the two groups(P>0.05).There was no obvious difference in cardiac function changes between the two groups by NYHA(~2=0.09,P=0.77)and Killip(~2=0.04,P=0.84)scores(P>0.05).There were no obvious differences(P>0.05)between the two groups for ICU stay time(t=-0.88,P=0.38),survival rate and mortality rate(t=0.26,P=0.60).Conclusion:BiPAP ventilator has obvious clinical effects on patients with acute heart failure,it can stabilizes their respiration and heart rate,reduces hypoxia,improves cardiac function,and reduces the rate of tracheal intubation.The application of bi-level positive airway pressure ventilation in the emergency department can significantly relieve the clinical symptoms of patients with acute heart failure and improve the clinical prognosis of patients,which has good clinical application value.