The Clinical Observation in Severe COPD and Respiratory Failure by Using Sequential Non-invasive Mechanical Ventilation After Invasive Mechanical Ventilation

Objective: To explore the clinical therapeutic effect and feasibility of sequential invasive and non-invasive mechanical ventilation in severe chronic obstructive pulmonary disease(COPD).Method: 19 patients with COPD underwent sequential invasive and non-invasive mechanical ventilation,and 16 patients with COPD underwent conventional treatment,to analyse and compare the APACHEⅡ score,PaO_2/FiO_2、PaCO_2,heart rate(HR),mean arterial and pressure invasive mechanical ventilation time,total mechanical ventilation time,total length of stay and incidence rate of repeated tracheal intubation,the incidence rate of ventilator associated pneumonia(VAP).Result: Sequential invasive and non-invasive mechanical ventilation in severe chronic obstructive pulmonary disease(COPD) had significant therapeutic effect,there was no significant difference of total mechanical ventilation time between the two groups,the total mechanical ventilation time of sequential invasive mechanical ventilation shortened(P0.05)and the incidence rate of repeated tracheal intubation in sequential invasive and non-invasive mechanical ventilation was lower than conventional treatment(P0.05),every index of respiration and circulation in sequential invasive mechanical ventilation were significantly improved compared with conventional treatment.Conclusion: Non-invasive mechanical ventilation can maintain the alveolar ventilation,improve the oxygenation and respiratory muscle fatigue,reduce invasive mechanical ventilation time and the incidence rate of total mechanical ventilation time and ventilator associated pneumonia(VAP),it can help the patients successfully remove the respirator and reduce the repeated tracheal intubation.