A Clinical Study on the Early Application of Non-invasive Positive Pressure Ventilation in Patients with Acute Heart Failure

WANG Meiying; DONG Junchan; YANG Xuhua; HOU Yunsheng; JIA Lijun; FU Lina; ZHANG Lei; WANG Li'ao

doi:10.3969/j.issn.1002-3429.2024.10.010

Abstract：Objective To investigate the clinical effect of non-invasive positive pressure ventilation in patients with acute heart failure(AHF).Methods A prospective randomized controlled study was conducted to select 200 patients with AHF who were treated for dyspnea from January 2021 to January 2024 as the research subjects,and they were divided into ob-servation group and control group by random number table method,with 100 cases in each group.The control group received conventional treatment,and the observation group received non-invasive positive pressure ventilation within 60 min of the onset of AHF based on the conventional treatment.The two groups were compared at admission and 24 h after admission with respect to vital signs[heart rate,respiratory rate,mean arterial pressure(MAP)],cardiac and pulmonary function indicators[par-tial pressure of arterial oxygen(PaO2),pulse oxygen saturation(SpO2),B-type brain natriuretic peptide(BNP),blood lac-tic acid(Lac),left ventricular ejection fraction(LVEF)],clinical treatment related indicators(non-invasive positive pres-sure ventilation time,length of hospital stay,the rate of tracheal intubation within 24 h),and the correlation between the total length of noninvasive positive pressure ventilation(d)and the time from admission to the use of noninvasive positive pressure ventilation(min)was analyzed.Results At 24 h after admission,the heart rate,respiratory rate,MAP and blood Lac levels in observation group were lower than those in control group,and PaO2,SpO2 and LVEF were higher than those in control group(P＜0.05).There was no significant difference in BNP between the two groups(P＞0.05).The total length of non-invasive positive pressure ventilation and hospital stay in the observation group were shorter than those in the control group,and the rate of tracheal intubation within 24 h was lower than that in the control group(P＜0.05).There was a significant and positive correlation between the time of noninvasive positive pressure ventilation(d)and the time from admission to the use of noninvasive positive pressure ventilation(min)(r=0.323,P=0.010).Conclusion Early application of non-invasive positive pressure ventilation in patients with AHF has obvious clinical effect,which can significantly improve the suc-cess rate of patient rescue and reduce the application rate of invasive mechanical ventilation.