Effect of invasive and noninvasive sequential mechanical ventilation on respiratory failure of critical cor pulmonale

Objective To observe and analyze the clinical effects of invasive and non-invasive sequential mechanical ventilation in the treatment of respiratory failure in patients with chronic pulmonary heart disease. Methods A total of 70 patients with chronic pulmonary ill heart disease and respiratory failure admitted to the First Hospital of Shanxi Medical University from January 2018 to March 2018 were enrolled in this study.The patients were randomly divided into control group and observation group according to the digital table, with 35 cases in each group.The control group received invasive mechanical ventilation treatment.The observation group used the pulmonary infection control window (PIC) as the switching point of invasive ventilation and non-invasive ventilation, and invasive and non-invasive sequential mechanical ventilation were given.The clinical indicators, blood gas indicators, respiratory rate and heart rate changes of the two groups were compared.The clinical efficacy of the two groups were observed to analyze. Results The invasive mechanical ventilation time, total ventilation time and hospitalization days in the observation group were (5.16±0.83)d, (7.79±0.63)d and (8.95±0.62)d, respectively, which were significantly shorter than those in the control group [(8.42±0.91)d, (11.48±0.95)d, (14.17±0.65)d], the differences were statistically significant(t=15.659, 19.151, 34.379, all P<0.05). After treatment, the PaO2 of the observation group was significantly higher than that of the control group[(85.19±5.07)mmHg vs.(79.95±4.68)mmHg], while the PaCO2[(49.85±4.17)mmHg vs.(53.36±4.82)mmHg], respiratory rate[(24.43±3.17)times/min vs.(31.19±4.08)times/min]and heart rate[(94.43±13.36)times/min vs.(113.36±17.13)times/min] in the observation group were significantly lower than those in the control group, and the total effective rate of the observation group (91.43%) was significantly higher than that of the control group(54.29%), the differences were statistically significant(t=4.493, 3.258, 7.740, 4.338, χ2=12.209, all P<0.05). Conclusion The clinical efficacy of invasive and non-invasive sequential mechanical ventilation in the treatment of patients with respiratory failure due to chronic pulmonary heart disease is significant, which can improve the clinical symptoms of patients and reduce the time of hospitalization. Key words: Pulmonary heart disease; Respiratory insufficiency; Ventilators, mechanical; Respiration, artificial; Blood gas monitoring, transcutaneous; Respiration; Heart rate; Length of stay; Controlled clinical trial