Optimal timing of noninvasive positive pressure ventilation for acute exacerbation of chronic obstructive pulmonary disease with respiratory failure patients in emergency department
Zhang Ying
Suo Min
Zhen Lei
Zhang Xiangqun
Wei Bing
Wang Xiao
Liu Yugeng
Zeng Hong
Abstract：Objective To investigate the optimal timing of noninvasive positive pressure ventilation (NPPV) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure in emergency department.Methods A total of 110 AECOPD patients with respiratory failure admitted to Department of Emergency,Western Hospital of Beijing Chaoyang Hospital,Capital Medical University from October 2015 to January 2019 were enrolled.According to the timing of NPPV,the patients were divided into early application group(58 cases) and delayed application group(52 cases).Clinical data,arterial blood gas indexes before and 2 h after NPPV,duration time of NPPV,endotracheal intubation rate and fatality rate were analyzed.Results Arterial partial pressure of oxygen and oxygen saturation of blood were significantly improved 2 h after NPPV in both groups(both P ＜0.05).In observation group,pH value(7.37 ±0.09 vs 7.28 ±0.08),arterial partial pressure of carbon dioxide (PaCO2) [(67 ± 14) mmHg vs (82 ± 19) mmHg],buffuer excess [10.5 (6.9,14.2) mmol/L vs 10.2(5.4,12.9) mmol/L] and lactic acid concentration[0.8(0.6,1.3) mmol/L vs 1.1 (0.7,1.6) mmol/L] were significantly improved after NPPV(all P ＜0.05).△pH and△PaCO2 in observation group were significantly higher than those in control group(both P ＜ 0.001).Duration time of NPPV in observation group was significantly shorter than that in control group [5.0 (2.0,9.3) d vs 6.5 (4.0,9.0) d] (P =0.048).There was no difference of intubation rate [3.8％ (2/52) vs 0] and in-hospital fatality rate [11.5％ (6/52) vs 3.4％ (2/58)] between control group and observation group.Conclusion Early application of NPPV in AECOPD patients with respiratory failure can effectively correct hypoxia and hypercarbia,ameliorate respiratory distress,improve clinical symptoms and shorten ventilation time.
Keywords：Chronic obstructive pulmonary diseaseRespiratory failureNoninvasive positive pressure ventilation
Publication Date：2019-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 858-861 )