Clinical analysis of double level positive airway pressure in the treatment of chronic obstructive pulmonary disease with respiratory failure

Abstract

Objective To observe the clinical effect of bi-level positive airway pressure (BiPAP) non-invasive ventilation (NIV) in the treatment of chronic obstructive pulmonary disease (COPD) with respiratory failure. Methods A total of 120 patients with COPD and respiratory failure who were treated in the Department of Respiratory Medicine of the Sixth People′s Hospital of Chengdu from January 2016 to December 2018 were selected as the research subjects.They were randomly divided into 2 groups, and the control group (n=60) was given conventional medication Nasal catheter low-flow oxygen inhalation therapy, the experimental group (n=60) was given conventional medication+ BiPAP combined with NIV treatment; the heart rate (HR), respiration rate (RR), pH value, partial pressure of carbon dioxide (PaCO2), partial pressure of oxygen in artery (PaO2), arterial oxygen saturation (SaO2), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1%pred, Acute Physiology and Chronic Health Evaluation scoring system (APACHE Ⅱ), blood gas improvement time hospital stay, complications before the statistical test group and control group patients were observed. Results The experimental group and the control group patients before treatment of HR, RR, pH and PaCO2, PaO2, SaO2, FVC, FEV1, FEV1%pred, APACHE Ⅱ there were no statistically significant difference comparing (t=1.306, 1.041, 1.058, 1.140, 1.026, 1.260, 1.021, 1.274, 1.165, 1.529, all P>0.05), but after treatment group comparison between HR, RR, pH, PaCO2, PaO2, SaO2, FVC, FEV1, FEV1%pred, APACHE Ⅱ each index difference were statistically significant (t=3.254, 3.985, 3.052, 4.162, 3.262, 5.124, 3.544, 3.127, 5.251, 3.184, all P<0.05). There were significant differences in blood gas improvement time, hospitalization time and complication rate between the experimental group and the control group (t=3.658, 5.187, χ2=26.359, both P<0.05). Conclusions BiPAP NIV can effectively treat COPD complicated with respiratory failure, but attention should be paid to strengthen targeted nursing intervention to reduce the risk of related complications. Key words: Pulmonary disease, chronic obstructive; Respiratory insufficiency; Bi-level positive airway pressure; Non-invasive ventilation; Clinical curative effect