JOURNAL ARTICLE

[Clinical value of noninvasive positive-pressure ventilation in chronic obstruction pulmonary disease combined with type II respiratory failure: a 4-year retrospective study]

Wei-bing Zhang, Xin-yan Wang, Xiao-yan Tian, Hui Zhang, Zhi-peng Wang, Yu-yan Gao
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, Chinese Critical Care Medicine, Zhongguo Weizhongbing Jijiuyixue 2008, 20 (10): 601-3
18926071

OBJECTIVE: To evaluate the value of noninvasive positive-pressure ventilation (NIPPV) in treatment of patients with chronic obstruction pulmonary disease (COPD) combined with type II respiratory failure (RF).

METHODS: From June 15th, 2002 to June 15th, 2006, there were 351 inpatients with COPD combined with type II RF. Those treated with NIPPV were categorized as treatment group; those who were not treated by NIPPV served as control group. All patients were divided into four subgroups according to results of blood gas analysis as follows. Mild RF group: 50 mm Hg < or = arterial partial pressure of carbon dioxide (PaCO2) < or = 65 mm Hg, 1 mm Hg=0.133 kPa; medium RF group: 66 mm Hg < or = PaCO2 < or = 80 mmHg; severe RF group: 81 mm Hg < or = PaCO2 < or = 95 mm Hg; extremely severe RF group: > or = 96 mm Hg. NIPPV was used in treatment group on top of conventional treatment. Values of blood gas analysis, length of stay, cost of hospitalization, rate of cannulation and fatality rate were observed in all groups before treatment and after treatment.

RESULTS: After being treated with NIPPV, all patients with COPD combined with type II RF in different degrees, arterial partial pressure of oxygen (PaO2) were raised in different degrees, and PaCO2 were all lowered in different degrees. Blood pH, PaO2 and PaCO2 showed statistically significant difference between treatment group and control group in severe and extremely severe RF patients (all P < 0.05). The length of stay of patients with RF in different degrees, was shortened obviously, also the cost of hospitalization, rate of cannulation and fatality rate were all significantly reduced in treatment group. In contrast to mild, medium RF patients, rate of cannulation and fatality rate were increased in extremely severe RF group (all P < 0.05).

CONCLUSION: NIPPV is beneficial to COPD combined with type II RF in different degrees.

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