Comparative Observation of Efficacy of Different Ventilator Parameters and Model Selection in the Treatment of Elderly Patients with COPD and Respiratory Failure

Jiang Haixia

doi:10.3969/j.issn.1004-5775.2025.11.012

Abstract：Objective:To explore the difference in efficacy of different ventilator parameters and model selections on elderly patients with COPD complicated with respiratory failure(RF).Methods:76 elderly patients with COPD and RF in the hospital were enrolled from April 2021 to September 2023.According to the random number table method,they were divided into SIMV+PSV group and BiPAP group,with 38 cases in each group.Both groups were treated with ventilator,and the SIMV+PSV group received synchronous intermittent mandatory ventilation(SIMV)+pressure support ventilation(PSV)model,while the BiPAP group was given bi-level positive airway pressure ventilation(BiPAP model).The blood gas indicators[blood oxygen saturation(SaO2),arterial partial pressure of carbon dioxide(PaCO2),arterial partial pressure of oxygen(PaO2)],airway respiratory mechanics indicators[inspiratory resistance(Rins),spontaneous breathing frequency,peak airway pressure(Ppeak),mean airway pressure(Pmean)],dyspnea degree[dyspnea index scale(mMRC)],chronic obstructive pulmonary disease assessment test[COPD assessment test(CAT)],incidence of ventilator-associated lung injury and mortality rate were compared between groups before and after treatment.Results:After treatment,SaO2 and PaO2 were increased and PaCO2 were decreased in both groups,with statistically significant difference between groups(t=3.628,2.861,4.892;P＜0.05).After treatment,the levels of Rins,Ppeak and Pmean in both groups were increased,and the spontaneous respiratory frequency was decreased,with statistically significant difference between groups(t=3.628,3.628,2.861,4.892;P＜0.05).After treatment,mMRC and CAT scores were decreased in both groups,and SIMV+PSV group was lower than BiPAP group,with statistically significant difference(t=5.192,2.933;P＜0.05).The incidence of ventilator-associated lung injury in SIMV+PSV group was lower than that in BiPAP group,and the difference was statistically significant(χ2=2.67,P＜0.05).The call fatality rate of SIMV+PSV group was lower than that of BiPAP group,and the difference was not statistically significant(χ2=0.33,P＞0.05).Conclusion:Compared with BiPAP model,SIMV+PSV ventilation model can promote the adjustment of blood gas status and airway respiratory function,improve the respiratory status and adjust the severity of COPD in patients with COPD complicated with RF.