Objective To investigate the effects of arterial blood gas index control during invasive mechanical ventilation on prognosis in COPD patients with type Ⅱ respiratory failure.
Methods Seventy-six COPD patients with hypercapnic respiratory failure who underwent invasive mechanical ventilation were recruited in the study. The patients were divided into group A with conventional arterial blood gas index control [pH of 7.40±0.05,PaO2 of (70±5)mm Hg,PaCO2 of (55±5)mm Hg],and group B with low index control [pH of 7.35±0.05,PaO2 of (60±5)mm Hg,PaCO2 of (60±5)mm Hg]. Two groups were compared on the required parameters of invasive mechanical ventilation,the duration of invasive mechanical ventilation,the incidence rate of sequential therapy in noninvasive mechanical ventilation,ventilator associated pneumonia and secondary intubation,etc.
Results The required parameters of invasive mechanical ventilation in group B including tidal volume (VT) and pressure support (PS),the duration of invasive mechanical ventilation,the incidence rate of sequential therapy in noninvasive mechanical ventilation,ventilator associated pneumonia and secondary intubation were all significantly lower than those in group A (P<0.05).
Conclusion The strategy to permit a lower PaO2 and carbon dioxide retention to a certain extent at lower FiO2,VT and PS levels in invasive mechanical ventilation can reduce the duration of invasive mechanical ventilation and the occurrence of ventilator associated complications,and improve the prognosis in COPD patients with type Ⅱ respiratory failure.
Citation:
YuChuang, ZhangZhenbao. Effects of Arterial Blood Gas Index Control during Invasive Mechanical Ventilation on Prognosis in COPD Patients with Hypercapnic Respiratory Failure. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(2): 132-134. doi: 10.7507/1671-6205.2015034
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- 1. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版).中华结核和呼吸杂志,2013,36:255-264.
- 2. MacIntyre NR,Cook DJ,Ely EW Jr,et al. Evidence-based guidelines for weaning and discontinuing ventilatory support:a collective task force facilitated by the American College of Chest Physicians;the American Association for Respiratory Care;and the American College of Critical Care Medicine.Chest,2001,120:375s-395s.
- 3. 葛慧青,袁月华,应可净,等.无创通气在机械通气撤离中的作用.中华急诊医学杂志,2010,19:69-73.
- 4. 叶任高,陆再英,主编.内科学. 第6版.北京:人民卫生出版社,2004,57-142.
- 5. 王蔚,童朝晖.呼吸机撤离技术的研究进展.中华结核和呼吸杂志,2010,33:379-381.
- 6. 邱海波,杜斌,马遂,等.生理呼吸功作为呼吸机撤离指标的临床研究.中华结核和呼吸杂志,1998,21:105-107.
- 7. 段俊峰,陈小菊,王涛,等.不同自主呼吸试验对慢性阻塞性肺疾病患者呼吸力学参数的影响.中国呼吸与危重监护杂志,2014,13:10-13.
- 8. 黄克武,王辰.呼吸肌疲劳与撤机.中华内科杂志,2002,41:137-139.
- 9. 唐柚青,郭振辉,邓青南,等.小潮气量通气对机械通气导致肺损伤及多器官衰竭中核因子-κB活性的影响.实用医学杂志,2007,23:1809-1811.
- 10. 雷国锋,张君平,王晓冰,等.小潮气量肺保护通气对呼吸机相关肺炎发生率及病情转归的影响.医学信息杂志,2014,27:603.