The therapeutic values of early application of noninvasive positive pressure ventilation in treating acute exacerbations of COPD with type II respiratory failure.

Objective To evaluate the therapeutic values of early application of noninvasive positive pressure ventilation(NiPPV) in treating acute exacerbation of chronic obstructive pulmonary disease with type Ⅱrespiratory failure.Methods 73 case of acute exacerbation of chronic obstructive pulmonary disease with type Ⅱ respiratory failure were divided into two groups.On the basis of a conventional treatment protocols,the control group were given oxygen therapy with nasal catherter additionally,while the treatment group were given NiPPV with bi-level positive airway pressure(BiPAP) model additionally.The clinical manifestations,respiratory rate,heart rate,the arterial blood gases paramelers,the scale for accessory respiratory muscles used,and the score of dyspnea were recorded before and after treatment.Results After treament,both groups had significant improvement in HR、RR、pH、PaO2 and PaCO2(P0.01).But improvement in pH、PaO2、PaCO2 in treatment group was more rapid and significant than that in control group at 24,48,72h(P0.01),and the lenth of hospital stay and hospital mortality of the treatment group were lower than that of the control group(P0.05).More cases of the control group needed to change treatment protocols than that of the treatment group(50% vs 13.5% P0.05).Conclusion The early application of noninvasive positive pressure ventilation in treating acute exacerbation of chronic obstructive pulmonary disease with type Ⅱ respiratory failure can rapidly improve the clinical symotoms,heighten arterial oxygen tension,lower PaCO2,shorten the length of hospital stay and lower the hospital mortality.