Research on Application of Invasive and Non-invasive Sequential Mechanical Ventilation in Patients With Neuromuscular Disease Complicated With Respiratory Failure

Objective: To study the clinical effect of invasive and non-invasive sequential ventilation in patients with neuromuscular disease complicated with respiratory failure.Methods: Fourty-one patients with neuromuscular disease complicated with respiratory failure were divided into routine mechanic ventilation group(group A,22 cases) and invasive and non-invasive sequential ventilation group(group B,19 cases).All the patients were treated by means of endotracheal intubation-mechanical ventilation(ETI-MV).22 cases in group A were continuously received invasive mechanical ventilation.These patients were gradually weaned by synchronized intermittent mandatory ventilation and pressure support ventilation mode.The early extubation was conducted when patient had enough strength to trigger ventilator and followed by non-invasive ventilation via facial mask immediately in group B.Results: For group A and group B,the duration of invasive mechanical ventilation was 15.7±6.2 and 10.2±4.6 days respectively(P0.05).The hospital stay of patients in group A was longer than that of group B(23.6±8.5 vs 16.3±7.2 days,P0.05).The incidence of ventilator associated pneumonia(VAP) in group A and group B were 45.5% and 15.8% respectively(P0.05).The weaning success rate of group A was lower than that of group B(54.5% vs 84.2%,P0.05).No significant difference was found in the survival rates of these two groups(P0.05).Conclusions: Early extubation followed by non-invasive ventilation can significantly decrease the durations of ventilatory support,the duration of hospital stay,the risk of VAP and increase the success rate of ventilator weaning.