A Prospective Study On The Duration Of Non-invasive Mechanical Ventilation For One-day Treatment Of Acute Exacerbation Of COPD Complicated With Type Ⅱ Respiratory Failure

Objective:This study investigated the duration of noninvasive mechanical ventilation for patients with acute exacerbation of COPD and type II respiratory failure in a single day,providing a theoretical basis for standardizing the selection of the duration of noninvasive mechanical ventilation for patients with acute exacerbation of COPD and type II respiratory failure in a single day.Methods:A total of 102 patients with acute exacerbation of chronic obstructive pulmonary disease and type II respiratory failure who were hospitalized in the respiratory department of Wuzhou People’s Hospital from January 2021 to July 2022 were selected as the research subjects.All patients received basic treatment（including antibiotics,bronchodilators,etc.）.Starting from the first day after admission,all study subjects were randomly divided into numerical groups,with 34 subjects in each group.The first group received non-invasive ventilator treatment for 6 hours per day;The second group received non-invasive ventilator treatment for 10 hours per day;The third group received non-invasive ventilator treatment for more than 16 hours per day.At 7:00 every day,the arterial blood of the patient was drawn（whenever necessary depending on the change of the condition）,blood gas analysis was performed,PH,Pa CO₂and Pa O₂levels were monitored,and complications were observed.The study time of each patient was 7 days.Among them,there are 79 males and 23 females,aged 51-91 years,with an average age of（73.6±8.1）years.（5）There was no statistically significant difference in the length of hospitalization between the 6h group and the 10h group,as well as between the 10h group and the≥16h group.Results:（1）Gender,age,COPD course,smoking index（SI）,blood gas analysis（p H,Pa CO2,Pa O2）,heart rate（HR）,respiratory rate（RR）,white blood cell（WBC）,hemoglobin（HGB）,neutrophil（NEU）,Alanine transaminase（ALT）,aspartate Transaminase（AST）,albumin（ALB）,creatinine（CRE）,D-dimer（D-D）,N-terminal pro brain natriuretic peptide（NT pro BNP）,pro Calcitonin（PCT）There was no statistically significant difference in body mass index and SOFA score（P>0.05）,indicating comparability.（2）There were statistically significant differences in p H,Pa O2,and Pa O2 among the three groups before and after 7 days of treatment（P<0.05）,while there was no statistically significant difference in p H and Pa O₂among the three groups after treatment（P>0.05）;However,there was a statistically significant difference in Pa CO₂between the three groups after treatment（P<0.05）.There was a statistically significant difference in Pa CO₂between the 6h group and the≥16h group,as well as between the 6h group and the 10h group（P<0.05）,while there was no statistically significant difference in Pa CO₂between the 10h group and the≥16h group（P>0.05）.（3）After 7 days of treatment,the condition of the three groups of patients improved and the treatment was effective,but there was no statistically significant difference in the effectiveness rate between the three groups before and after treatment（P>0.05）.（4）There was no statistically significant difference in the incidence of complications between the 6h group and the 10h group,as well as between the 10h group and the≥16h group（P>0.05）.However,there was a statistically significant difference in the incidence of complications between the6h group and the≥16h group（P<0.05）.Conclusion:（1）When the single day treatment duration of NIPPV in patients with AECOPD and type II respiratory failure is≥6 hours,the longer the single day treatment duration,the more effective it is to reduce arterial blood partial pressure of carbon dioxide（Pa CO₂）,but the PH value and Pa O₂are not related to the single day treatment duration of NIPPV;（2）Non invasive ventilation for up to 6 hours per day can effectively improve the patient’s condition,but over 6 hours per day does not significantly improve the effective rate;（3）The longer the duration of single day treatment with non-invasive ventilator,the higher the incidence of adverse reactions in AECOPD patients.（4）The duration of NIPPV single day treatment in AECOPD patients with type II respiratory failure is not related to their length of hospital stay.