Clinical Application of Noninvasive Positive Pressure Ventilation in Patients with Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

Objective: To evaluate the clinical effects of noninvasive positive pressure ventilation (NPPV) for patients with chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure. Methods: 42 patients with COPD complicated with type Ⅱrespiratory failure were randomly divided to receive conventional therapy (conventional therapy group) or NPPV with the conventional therapy (NPPV group). NPPV was delivered to patients by a face mask connected to a ventilator set in pressure support ventilation (PSV) and positive end expiratory pressure (PEEP). Arterial blood gases, respiratory rate (RR), heart rate, and blood pressure were measured at 1 and 6 hours after therapy, and then once each day since the 2nd day. Results: In NPPV group, there was a significant improvement of PaO 2 and RR in 1 and 6 hours after therapy. PaCO 2 and pH were improved obviously 6 hours after therapy compared with baseline ( P 0.05 ). In conventional therapy group, arterial blood gases and RR showed no significant differences at 1 and 6 hours after therapy ( P 0.05 ). While in NPPV group, PaO 2, PaCO 2, pH were significantly improved 24 hours and 72 hours after therapy compared to that of conventional therapy group ( P 0.05 ). Failure rate of treatment was markedly lower and the average stay in hospital were shorter in the NPPV group than that in the conventional therapy group ( P 0.05 ). Conclusion: NPPV is an effective ventilatory pattern for patients with COPD complicated with type Ⅱrespiratory failure. Application of NPPV can improve artery blood gases and clinical signs, decrease the duration of hospitalization. NPPV may be regard as the first choice of ventilatory therapy for patients with COPD complicated with type Ⅱ respiratory failure.