Clinical efficacy of sequential invasive and non-invasive mechanical ventilation in the treatment of severe respiratory failure
Objective To analyze the clinical value of sequential invasive and non-invasive mechanical ventilation in the treatment of severe respiratory failure. Methods 90 patients with severe respiratory failure were selected and divided into the control group (45 cases,invasive mechanical ventilation) and the observation group (45 cases,sequential invasive and non-invasive mechanical ventilation) according to random numerical table. The therapeutic effects,clinical indicators,blood gas parameters,pulmonary function,and prognosis were compared between the two groups. Results The success rate of resuscitation of 97.97％ in the observation group was higher than 84.44％ in the control group,and the incidence of ventilator-associated pneumonia (VAP) of 6.67％ was lower than 22.22％ in the control group (P<0.05). In the observation group,the duration of invasive mechanical ventilation was (7.12±1.31) d,the oxygen supply time was (11.26±2.71) d,the length of intensive care unit (ICU) stay was (17.88±3.51) d and the total hospital stay was (20.62±4.77) d,which were all shorter than (15.74±3.55),(18.72±4.32),(29.02±4.23) and (36.79±4.93) d in the control group (P<0.05). Compared with before treatment,PaO2,pH and PaCO2 were improved in both groups after treatment;the observation group had PaO2 of (85.67±4.35) mm Hg (1 mm Hg=0.133 kPa) and pH value of (7.37±0.08) after treatment,which were higher than (81.33±4.12) mm Hg and (7.25±0.03) in the control group;PaCO2 of (42.03±2.11) mm Hg in the observation group was lower than (45.32±2.32) mm Hg in the control group (P<0.05). Compared with before treatment,the pulmonary function indexes in both groups were improved after treatment;in the observation group,the peak expiratory flow rate (PEF) was (371.56±15.21) L/min and the forced expiratory volume in one second (FEV1)was (3.25±0.32) L after treatment,which were better than (312.56±15.82) L/min and (2.30±0.26) L in the control group (P<0.05). Compared with before treatment,the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score and Pneumonia Severity Index (PSI) score in both groups were significantly decreased after treatment;the observation group had APACHEⅡ score of (12.21±3.02) points and PSI score of (41.75±4.18) points after treatment,which were lower than (15.24±3.16) and (47.02±4.61) points in the control group (P<0.05). Conclusion In the treatment of severe respiratory failure,the use of sequential invasive and non-invasive mechanical ventilation can optimize the hemodynamic indicators and lung function,improve the success rate of resuscitation,and effectively shorten the hospital stay and prognosis,which is worthy of reference and learning.
Invasive mechanical ventilationSequential non-invasive mechanical ventilationSevere respiratory failureBlood gas indicatorsLung function
万方数据
维普
