Efficacy evaluation of noninvasive and invasive sequential mechanical ventilation on chronic obstructive pulmonary disease with severe respiratory failure

Objective To evaluate the effects of noninvasive and invasive sequential mechanical ventilation on chronic obstructive pulmonary disease (COPD) acute exacerbation period with severe respiratory failure.Methods Thirty-seven COPD patients in acute exacerbation period with severe respiratory failure were divided into noninvasive and invasive sequential mechanical ventilation treatment group (sequential group of 19 cases) and single mechanical ventilation treatment group (non-sequential group of 18 cases) according to the different ways of mechanical ventilation.The time of mechanical ventilation,the success rate of mechanical ventilation removement,the machine ventilator-associated pneumonia (VAP) incidence,the time of ICU admission were recorded and compared between the two groups,and the indexes of sequential group during noninvasive ventilation were recorded.Results The effect of sequential mechanical ventilation on COPD acute exacerbation period with severe respiratory failure was good,the mechanical ventilation time,ICU admission time of sequential group were shortened,compared with non-sequential group ( P ＜ 0.05 ).The success rate of mechanical ventilation removement,VAP incidence and reintubation rate were lower than those of the non-sequential group ( P ＜ 0.05 ).In sequential group,after the endotracheval catheter removal,convert to noninvasive mechanical entilation after 3 h,the ventilation indexes,respiratory function,circulation function compared with before drawing tube,there was no significant difference (P ＞ O.05).Conclusions The effect of noninvasive and invasive sequential mechanical ventilation on acute exacerbation period of chronic obstructive pulmonary disease with severe respiratory failure is superior. Key words: Sequential mechanical ventilation ;  Chronic obstructive pulmonary disease acute exacerbation period ;  Respiratory failure ;  Lung infection control window