Clinical Research of Sequential Invasive to Noninvasive Ventilation on Treatment of Respiratory Failure Due to Chronic Obstructive Pulmonary Disease

Objective To investigate the therapeutic efficacy of sequential invasive to noninvasive ventilation for acute exacerbation of chronic obstructive pulmonary disease(COPD) complicated with severe respiratory failure.Methods The cases were assigned to 2 groups: invasive ventilation group(n=20) and sequential invasive to noninvasive ventilation group(n=23).Pulmonary infection control window(PICW) was defined as switching point from invasive ventilation to noninvasive ventilation.The main clinical parameters observed were: the invasive ventilation period,total ventilation period,reintubation rate within one week,length of stay in ICU(RICU),incidence of ventilator-associated pneumonia(VAP)and changes of arterial blood gas,heart rate,blood pressure in sequential invasive to noninvasive ventilation group.Results The invasive ventilation period and length of stay in ICU(RICU) of the cases in sequential invasive to noninvasive ventilation group were significantly shorter than that in invasive ventilation group(P0.05).Incidence of VAP and rein-tubation rates were lower in sequential invasive to noninvasive ventilation group than that in invasive ventilation group(P0.05).After all cases received noninvasive ventilation,the changes of pH、PaO2,PaCO2,PaO2/FiO2,heart rate,and SBP in sequential invasive to noninvasive ventilation group were not significant(P0.05).Conclusion The results of sequential invasive to noninvasive ventilation is better than that of invasive ventilation for COPD with acute exacerbation resulting in severe respiratory failure as shown by effectively decreasing the invasive ventilation period,reducing the incidence of VAP and improving the patients' prognosis.