Clinical Observation of Sequential Invasive to Noninvasive Ventilation on Treatment of II-type Respiratory Failure Due to Chronic Obstructive Pulmonary Disease

Objective:To explore the efficacy of the application of sequential invasive to noninvasive ventilation on treatment of Ⅱ-type respiratory failure due to chronic obstructive pulmonary disease(COPD).Methods:77 patients with COPD Ⅱ-type respiratory failure requiring mechanical ventilation were randomly divided into the sequential group(n=35),and the conventional group(n=32).All patients underwent endotracheal intubation and mechanical ventilation.The conventional group chose a non-invasive ventilator mode(BiPAP) until the pulmonary infection control(PIC) the window appeared.Meanwhile,the conventional group chose maintained mechanical ventilation to the end.The main indicators of the two groups were observed and the blood gas changes between extubation and 4h BiPAP treatment in the sequential group were recorded.Results:In the sequential group,the invasive ventilation was(73.58±30.17) h,the re-interpolation rate was 5.7 percent and the incidence of VAP was 2.9%.All of them were significantly lower than those in the conventional group.The differences were statistically significant(all P=0.000).The differences of total mechanical ventilation duration and RICU hospitalization time in the two groups were similar.The differences were not statistical significant(total mechanical ventilation duration:P=0.958;RICU hospitalization time:P=0.654).After BiPAP was applied in the sequential group,the differences in pH,PaO 2,PaCO 2,HR and MAP were similar with those in extubation period.The differences were not statistically significant(all P0.05).Conclusion:Sequential invasive to noninvasive ventilation can significantly shorten the duration of mechanical ventilation,reduce the re-interpolation rate,and the incidence of VAP.It can improve Ⅱ-type respiratory failure due to COPD when combined with effective nursing care.