Clinical Study on Invasive and Non-invasive Sequential Mechanical Ventilation in Treatment of the Elderly With Chronic Obstructive Pulmonary Disease

Objective:To explore the therapeutic effect of invasive and non-invasive sequential mechanical ventilation on the elderly with severe chronic obstructive pulmonary disease (COPD) complicating respiratory failure. Methods:Forty-six elderly patients with COPD complicating with respiratory failure receiving early tracheal intubation were randomly divided into invasive and non-invasive sequential mechanical ventilation group (treatment group) and invasive mechanical ventilation group (control group). Tracheal intubation was taken out in patients of treatment group when pulmonary infection control (PIC) window appeared,and nasal mask were applied and gradually reduce pressure parameters until weaning success. Patients in control group continued invasive ventilation treatment,and SIMV frequency and PSV level were gradually reduced until weaning success. Time of invasive ventilation,total time of mechanical ventilation,ventilator associated pneumonia (VAP) and the stay in ICU were observed in two groups. Results:Time of invasive ventilation and total time of mechanical ventilation were significantly shorter in treatment group than those in control group (P0.05),the incidence of VAP decreased and the stay in ICU was significantly less in treatment group (P0.05). Conclusions:Invasive and non-invasive sequential mechanical ventilation may shorten the time of mechanical ventilation and stay in ICU,decrease the incidence of VAP in the elderly patients with severe COPD complicating respiratory failure after PIC window appeared.