Clinical effect of noninvasive sequential mechanical ventilation on ICU patients with severe COPD complicated with respiratory failure
Objective To analyze the clinical effect of noninvasive sequential mechanical ventilation in patients with severe chronic obstructive pulmonary disease(COPD)complicated with respiratory failure in intensive care unit(ICU).Methods 78 ICU patients with severe COPD complicated with respiratory failure were divided into the reference group and the experimental group according to coin tossing method,with 39 cases in each group.The reference group underwent invasive mechanical ventilation,and the experimental group underwent noninvasive sequential mechanical ventilation.Both groups were compared in terms of duration of ICU stay,mechanical ventilation time,occurrence of ventilator-associated pneumonia,arterial blood gas index[pH,arterial partial pressure of carbon dioxide(PaCO2),arterial partial pressure of oxygen(PaO2)],serum inflammatory cytokines[tumor necrosis factor-α(TNF-α),nuclear factor-κB(NF-κB),interleukin-6(IL-6)]expression levels.Results After 4 h of treatment,the pH,PaCO2 and PaO2 of the experimental group were(7.35±0.07),(62.31±8.57)mm Hg(1 mm Hg= 0.133 kPa)and(64.82±10.17)mm Hg,and those in the reference group were(7.29±0.05),(73.31±11.26)mm Hg and(51.53±8.25)mm Hg.After 36 h of treatment,the pH,PaCO2 and PaO2 of the experimental group were(7.36±0.05),(51.98±6.02)mm Hg and(72.61±11.08)mm Hg,and those in the reference group were(7.31±0.06),(63.21±10.69)mm Hg and(56.17±9.22)mm Hg.The pH and PaO2 of the experimental group were significantly higher than those of the reference group after 4 and 36 h of treatment,while PaCO2 was significantly lower than that of the reference group,and the statistical significance was established(P<0.05).The duration of ICU stay of(12.15±1.68)d and mechanical ventilation time of(10.08±1.74)d in the experimental group were shorter than(20.63±3.27)and(19.82±2.53)d in the reference group,and the statistical significance was established(P<0.05).The incidence of ventilator-associated pneumonia in the experimental group was lower than the reference group,and the statistical significance was established(χ2=3.924,P=0.048<0.05).The levels of TNF-α,NF-κB and IL-6 in the experimental group were(2.08±0.57)pg/ml,(6.48±1.12)ng/ml and(10.62±2.39)pg/ml after 3 months of treatment,which were significantly lower than(3.31±0.74)pg/ml,(9.49±1.34)ng/ml and(15.31±3.15)pg/ml in the reference group,and the statistical significance was established(P<0.05).Conclusion Noninvasive sequential mechanical ventilation therapy for ICU patients with severe COPD complicated with respiratory failure can effectively improve ventilation function,reduce complications,shorten the course of the disease,and alleviate inflammatory reaction,which is worthy of popularization and application.
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