The therapeutic value of non-invasive ventilation with AVAPS mode in COPD patients with type Ⅱ respiratory failure
Objective This study aims to analyze the therapeutic value of non-invasive ventilation with AVAPS mode in COPD patients with type Ⅱ respiratory failure.Methods A total of 82 COPD patients with type Ⅱ respiratory failure admitted to Liangxiang hospital were included in the study based on inclusion and exclusion criteria.The patients were randomly divided into two groups,the control group(n= 42)receiving BiPAP S/T mode with internal medical treatment,and the observation group(n= 40)receiving AVAPS mode(S/T + VT target)with the same internal medical treatment.The changes in arterial blood gas parameters,ventilation effectiveness,and incidence of ventilator-related complications were observed.Results In the control group,5 patients were intolerant to the ventilator,and 8 patients failed treatment and required endotracheal intubation.In the observation group,2 patients were intolerant to the ventilator,and 3 patients required endotracheal intubation.However,after intubation,the 18 patients above were transferred to the RICU and no deaths occurred.Other patients in both groups recovered and were discharged.At 6～8 hours,1 day,3 days,and 7 days of ventilator treatment,the observation group showed a better increase in pH and decrease in PaCO2 compared to the control group,but the difference was not statistically significant(P>0.05).After mechanical ventilation,the observation group had higher ventilation parameters VT(520.00±50.00)ml and VE(9.77±1.30)L/min compared to the control group,while RR(16.00±1.00)times/min and Lleak(18.00±6.00)L/min were significantly lower in the observation group than the control group.The differences in TA(7.35±2.44)h and TB(52.89±9.85)h between the two groups were statistically significant(t=9.979,6.999,11.366,9.347,7.944,11.672,P<0.05).The compliance rate of mechanical ventilation in the observation group(90.0%)was higher than in the control group(71.43%)(χ2 = 4.499,P<0.05).The incidence of endotracheal intubation(7.50%),facial pressure sores(7.50%),and gastrointestinal distension(5.00%)in the observation group were lower than in the control group,and the differences were statistically significant(P<0.05).The occurrence of aspiration pneumonia(2.50%)and conjunctivitis(2.50%)in the observation group was lower than in the control group,with statistically significant differences(P<0.05).Conclusion Non-invasive ventilation with AVAPS mode reduces the work of breathing in COPD patients with type Ⅱrespiratory failure,improves patient-ventilator synchrony,and demonstrates certain advantages compared to BiPAP mode.
Non-invasive ventilationaverage volume assured pressure support modeCOPD with type Ⅱ respiratory failureValue
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