Application of invasive-noninvasive sequential ventilation in the treatment of severe respiratory failure patients with COPD

Objective To evaluate the value of invasive-noninvasive sequential ventilation in the treatment of severe respiratory failure patients with COPD.Methods 30 cases of severe hypercapnic respiratory failure with AECOPD were collected as an invasive-noninvasive sequential ventilation group.When pulmonary infection control(PIC)window appeared,the early extubation was conducted immediately and followed by noninvasive ventilation.Another 30 cases with similar clinical characteristics were compared as a conventional ventilation group.When PIC window appeared,the invasive ventilation continued.The weaning successful rate,VAP incidence rate,reintubation rate,mortality rate,noninvasive ventilation time,total ventilation time,the duration of ICU stay were observed in the two groups and changes of heart rate,respiratory rate,blood pressure and arterial blood gas were observed in sequential ventilation group.Results The VAP incidence rate,mortality rate,noninvasive ventilation time,total ventilation time in sequential ventilation group were lower than thost in the conventional group(P﹤0.05).The weaning successful rate was higher than that in the conventional group(P﹤0.05).The reintubation rate was not different with that in the conventional group(P﹥0.05).The changes of pH,PaO2,PaCO2,PaO2 /FiO2,HR,RR and Bp in the sequential ventilation group were not significant(P﹥0.05).Conclusion The result of sequential invasive-noninvasive ventilation is better than that of invasive ventilation for hypercapnic respiratory failure with AECOPD.It can effectively decrease the invasive ventilation period and improve the weaning successful rate.