Effect of planed sedation at night on the mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease

doi:10.3969/j.issn.1002-1949.2015.11.008

Abstract：Objective To investigate the effect of planed sedation at night on the mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods This retrospective study included 101 cases of AECOPD patients who admitted to our hospital between October 2012 to February 2015 , and the inclusion criteria were patients with clear consciousness and mechanical ventilation .According to random number table method , they were randomly divided into two groups , study group (58 cases) and control group (43 cases);the patients in control group were given including anti -infection, glucocorticoid, eliminating phlegm and relieving asthma and other conventional treatment , and the patients in the study group during day time were given the psychological care program for nursing , and during night time (21:00 to the next day 7:00) were given midazolam or propofol sedation .The control group was treated with the above mentioned drugs , and the daily morning was performed to wake up to 1-2 hours.Two groups of sedation therapy had been continued until the end of the patient's final weaning .The incidence of ventilator associated pneumonia ( VAP ) in the two groups was observed , and the incidence of pulmonary ventilation , mechanical ventilation time and ICU time were observed .Results There was no significant difference in the incidence of VAP between the two groups (P>0.05).The incidence of atelectasis in the study group was significantly lower than that in the control group (P<0.05).The mechanical ventilation time and the time of ICU stay in the study group was significantly shorter than those in the control group ( P<0.05 ) .Conclusion The scheme of night time planning can reduce the incidence of atelectasis , and significantly shorten the mechanical ventilation time and ICU time in patients with AECOPD , which has a certain clinical application value .