Efficacy of Non-invasive Bi-level Positive Airway Pressure Ventilation in the Patients with Type II Respiratory Failure due to Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective: To evaluate the clinical effect of non-invasive Bi-level positive airway pressure ventilation(BiPAP) in the patients with type Ⅱ respiratory failure who suffered from acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods: The patients in control group(30 cases) who suffered from AECOPD with type Ⅱ respiratory failure were treated with conventional therapeutic management such as antibiotic,receiving continual low-flow oxygen,pacifying gasp,eliminating phlegm.Thirty-eight patients of AECOPD with type Ⅱ respiratory failure in experiment group were treated with BiPAP as well as conventional therapeutic management.Arterial blood gases were analyzed.The changes of clinical signs and the plasma level of endothelin-1 were observed,and the duration of hospital stay and the rate of mortality and endotracheal intubation were recorded after treatment.Results: The data of arterial blood gases,pH,PaO2,SaO2,PaO2/FiO2 in experiment group were higher significantly than those in control group after 4 h,24 h and 72 h BiPAP treatment,but PCO2 declined significantly(P0.05).There was significant difference in respiratory rate,heart rate,and white cell count between the experiment group and the control group(P0.05).The plasma level of endothelin-1 decreased faster in the experiment group than that in the control group,so did hospital days,endotracheal intubation rate and mortality rate(10.5±5.4 vs.18.7±8.5;10.5% vs.30.0%;7.8% vs.20.0%,respectively)(P0.05).Conclusion: BiPAP is an effective therapy for the patients with AECOPD combined type Ⅱ respiratory failure.It can reduce duration of hospital stay and decrease the intubation rate and mortality rate.