RESEARCH ON BI-LEVEL NONINVASIVE POSITIVE PRESSURE VENTILATION IN THE TREATMENT OF INVASIVE-NONINVASIVE SEQUENTIAL VENTILATION

[Objective]To evaluate the value of invasive-noninvasive sequential ventilation in the treatment of severe respiratory failure patients with COPD.[Methods]Used clinical trial to collect severe respiratory failure patients with COPD,then invasive ventilation through trachea cannula was carried out. When pulmonary infection control(PIC)window appeared,the patients were randomly divided into two groups. BiPAP sequential mechanical ventilation(MV)was carried out in one group,SIMV+PSV conventional ventilation was carried out in the other group. The weaning successful rate,VAP incidence rate,reintubation rate,mortality rate,noninvasive ventilation time,total ventilation time were observed in two group and changes of arterial blood gas,heart rate,respiratory rate and blood pressure were observed in sequential MV group.[Results]VAP incidence rate,mortality rate,noninvasive ventilation time,total ventilation time in sequential MV group were lower than that in the conventional group(P﹤0.05),weaning successful rate was higher than that in the conventional group(P﹤0.05),reintubation rate was not different with that in the conventional group(P﹥0.05). The changes of pH,PaO2,PaCO2,PaO2/FiO2,HR,RR and Bp in sequential MV group were not significant(P﹥0.05).[Conclusion]BiPAP ventilation is a more effective weaning way for the severe respiratory failure patients with COPD comparing to SIMV+PSV.