Study on effect of invasive and noninvasive sequential mechanical ventilation in patients with severe respiratory failure
Objective To exploer the effect of invasive and noninvasive sequential mechanical ventilation in patients with severe respiratory failure.Methods 86 patients with severe respiratory failure were divided into a control group and an observation group by random number table method,with 43 cases in each group.The control group was treated with conventional invasive mechanical ventilation,and the observation group was treated with invasive and noninvasive sequential mechanical ventilation.Both groups were compared in terms of blood gas analysis indicators[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),arterial oxygen saturation(SaO2)]and lung function indicators[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),peak expiratory flow rate(PEF)]before and after treatment,treatment duration(duration of invasive ventilation,total duration of mechanical ventilation),length of hospital stay,stress response indicators[norepinephrine(NE),epinephrine(E),angiotensin Ⅱ(ATⅡ)],vital signs(heart rate,respiratory rate)and therapeutic effect(success rate of ventilation weaning,re-intubation rate,incidence of ventilator-associated pneumonia)after treatment.Results After treatment,PaO2 and SaO2 in both groups were higher than those before treatment,and PaCO2 was lower than that before treatment;PaO2 of(73.03±5.35)mm Hg(1 mm Hg=0.133 kPa)and SaO2 of(92.46±4.60)%in the observation group were higher than(66.24±4.97)mm Hg and(85.18±3.79)%in the control group;PaCO2 of(41.09±0.54)mm Hg in the observation group was lower than(44.98±0.63)mm Hg in the control group(P<0.05).After treatment,FEV1,FVC and PEF in both groups were higher than those before treatment;the observation group had FEV1 of(3.21±0.34)L,FVC of(3.89±0.29)L and PEF of(3.35±0.60)L/s,which were higher than(2.29±0.24)L,(2.74±0.21)L and(2.90±0.71)L/s in the control group(P<0.05).The duration of invasive ventilation,total duration of mechanical ventilation and length of hospital stay in the observation group were(6.07±1.21),(8.70±1.53)and(12.33±1.82)d,which were shorter than(11.46±1.77),(11.46±1.77)and(18.64±2.35)d in the control group(P<0.05).After treatment,the levels of stress response indexes of NE,E and ATⅡ in the observation group were(122.80±17.92)ng/ml,(94.52±8.52)ng/ml and(31.05±2.98)pg/ml,which were lower than(209.59±21.06)ng/ml,(164.45±11.67)ng/ml and(55.69±4.13)pg/ml in the control group(P<0.05).After treatment,the heart rate and respiratory rate of the observation group were(88.21±4.87)beats/min and(15.98±0.81)times/min,which were lower than(95.70±6.13)beats/min and(19.59±1.25)times/min of the control group(P<0.05).The success rate of ventilation weaning of 93.02%(40/43)in the observation group was higher than 72.09%(31/43)in the control group;the re-intubation rate in the observation group was 2.33%(1/43)and the incidence of ventilator-associated pneumonia was 4.65%(2/43),which were lower than 18.60%(8/43)and 20.93%(9/43)in the control group(P<0.05).Conclusion In the treatment of patients with severe respiratory failure,the therapeutic effect of invasive and non-invasive sequential mechanical ventilation is accurate,which can help speed up the recovery of patients,promote the improvement of blood gas analysis indicators and lung function of patients,reduce the stress response of patients,improve the success rate of ventilation weaning,reduce the risk of ventilator-associated pneumonia,and has high feasibility for promotion.
Invasive mechanical ventilationSevere respiratory failureInvasive and non-invasive sequential mechanical ventilationBlood gas analysis indicators