Sequential mechanical ventilation in some patients of chronic obstructive pulmonary disease with respiratory failure

XIN Shao-bin; WEI Hai-ling

doi:10.3760/cma.j.issn.1673-4777.2011.10.012

Abstract：Objective To investigate the respiratory therapy when noninvasive positive pressure ventilation (NIPPV) is effective but intolerant in chronic obstructive pulmonary disease(COPD) with type Ⅱ respiratory failure. Methods Forty-three COPD patients with respiratory failure, to whom NIPPV was effective but intolerant,were divided randomly into control(n =25) and treatment group( n = 18). The control group patients were treated sequentially by NIPPV. The treatment was replaced by invasive positive pressure ventilation (IPPV) when NIPPV was ineffective. The treatment group patients were treated by IPPV. Based on patients condition, IPPV was early weaned and patients were treated sequentially by NIPPV. Mortality, the average hospital cost and the average hospital days were compared after the treatment. Results In the 25 cases of the control group, 21 cases recovered and 4 cases died. The mortality was 16.0％. The average hospital cost was 50 766 ±21 082 CNY and the average hospital days were (16.6 ±4.9)d. In the 18 cases of the treatment group, 17 cases recovered and 1 case died. The mortality is 5.5％. The average hospital cost was 78 576 ±25 540 CNY and the average hospital days were (13.7 ±5.1)d.The mortality of the treatment group was lower than that of the control group; the average hospital days of the treatment group was lower than those of the control group; the average hospital cost of the treatment group was higher than that of the control group. Conclusions When NIPPV is effective but intolerant to COPD with type Ⅱ respiratory failure, the mortality of the sequential mechanical ventilation is lower than that of the conventional mechanical ventilation. Sequential mechanical ventilation has less hospital days but more hospital cost.