Sequential invasive and noninvasive ventilation as treatment of respiratory failure due to chronic obstructive pulmonary disease

Objective: To investigate the therapeutic efficacy of sequential invasive and noninvasive ventilation for acute exacerbation of chronic obstructive pulmonary disease(COPD) complicated with severe respiratory failure.Methods: A total of 83 patients with chronic obstructive pulmonary disease(COPD) complicated with severe respiratory failure were randomly divided into observed group(44 cases) and control group(39 cases),patients in control group only received invasive ventilation,while others received invasive and 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,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 of the observed group were significantly shorter than that of control group(P0.05).Incidence of VAP and reintubation rates were lower in observation group than that in control group(P0.05).After all cases received noninvasive ventilation,the difference in pH、PaO2,PaCO2,PaO2 / FiO2,heart rate,and SBP in observeation group were not significant(P0.05).Conclusion:Sequential invasive to noninvasive ventilation is better than that of invasive ventilation for COPD with acute exacerbation resulting from severe respiratory failure,as it can effectively decreasing the invasive ventilation period,reduce the incidence of VAP and improve the patients' prognosis.