Effects of Noninvasive Ventilation Combined with Atomization Inhalation on Arterial Blood Gases and Pulmonary Function of Elderly Patients with Chronic Obstructive Pulmonary Disease Accompanied by Respiratory Failure

REN Bo-chen; WANG Chun-mao; SUN Jian; ZHANG Wei; LI Yun-hui

doi:10.3969/j.issn.1002-3429.2017.06.032

Abstract：Objective To investigate effects of noninvasive ventilation combined with atomization inhalation on arterial blood gases and pulmonary function of elderly patients with chronic obstructive pulmonary disease (COPD) accompanied by respiratory failure (RF).Methods A total of 98 patients with COPD-RF admitted during July 2015 and June 2016 were divided into combined group (n=49) and noninvasive ventilation group (n=49) according to random number table method.All the patients received conventional therapy and non-invasive positive pressure ventilation, and combined group was added with atomization inhalation.In two groups, changes of arterial blood gases indexes such as arterial oxygen tension (PaO2), partial pressure of carbon dioxide (PaCO2), hydrogen ion concentration (pH) were observed;changes of forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR), forced vital capacity (FVC) and respiratory rate (RR) were detected;level changes of inflammatory factors such as matrix metalloproteinase-9 (MMP-9), high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor alpha (TNF-α) were detected;incidence rate of adverse reactions during treatment and clinical effects were recorded.Results Compared with those before treatment in same group, levels of PaO2, pH, FEV1, PEFR and FVC were significantly increased, while PaCO2, RR, MMP-9, hs-CRP and TNF-α levels were significantly decreased after treatment in two groups (P<0.05).After treatment, in combined group PaO2, FEV1, PEFR and FVC levels were significantly higher, while PaCO2, RR, MMP-9, hs-CRP and TNF-α levels were significantly lower than those in noninvasive ventilation group (P<0.05).The total effective rate were 93.88% in combined group and 73.47% in noninvasive ventilation group respectively, and the difference was statistically significant (P<0.05).No obvious adverse reaction was found during treatment in two groups.Conclusion Noninvasive ventilation combined with atomization inhalation in treatment of elderly patients with COPD-RF can significantly improve arterial blood gases and pulmonary function and decrease inflammatory response without obvious adverse reaction.