A Clinical Study on Early Use of Noninvasive Ventilation and Delayed Use of Noninvasive Ventilation in the Treatment of Acute Left Heart Failure and Type Ⅱ Respiratory Failure

WANG Wen-hu; LI Wen-ping

doi:10.14033/j.cnki.cfmr.2015.36.005

Abstract：Objective:To compare the clinical effect of early use of noninvasive ventilation and delayed use of noninvasive ventilation in the treatment of acute left heart failure and type Ⅱ respiratory failure.Method:166 patients with the acute left heart failure and type Ⅱ respiratory failure diagnosed and treated in this hospital from June 2013 to May 2015 were divided into the research group and the control group according to the random number table,with 83 cases in each group.Patients in the control group were given the routine treatment and low-flow oxygen.After 1-2 h,in case of no obvious improvement on the respiratory function,the noninvasive ventilation was adopted.In addition to the routine treatment,patients in the research group were given the noninvasive ventilation immediately.The physical signs and blood gas indices before and after the treatment were compared between two groups,as well as the therapeutic effect and length of hospital stay.Result:All patients survived.There were no significant difference in the heart rate,respiration,mean arterial pressure and arterial partial pressure of oxygen before the treatment between two groups(P>0.05),while these four indices for patients both groups were significantly improved after the treatment(P<0.05).The degree of improvement for above indices in the research group were significantly better than those in the control group(P<0.05).The effective rate in the research group was 83.13% and its invasive ventilation rate was 16.87%;the effective rate in the control group was 60.24% and its invasive ventilation rate was 39.74%.The effective rate of noninvasive ventilation in the research group was significantly higher than the one in the control group(P<0.05).Meanwhile,the length of hospital stay for patients in the research group was significantly shorter than that in the control group(P<0.05).Conclusion:The early use of noninvasive ventilation in the treatment of acute left heartfailure and type Ⅱ respiratory failure can rapidly relieve the symptoms and signs,improve the blood gas indices,optimize the hypoxemia,greatly reduce the risk of transfer of invasive ventilation,and then significantly shorten the length of hospital stay.