Clinical Efficacy of Noninvasive Positive-pressure Ventilation for Elderly Patients with Chronic Obstructive Pulmonary Disease Combined with Left Heart Failure_West China Medical Journal

Authors：

 HEQian , HEYa-rong , CAOYu

Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

Keywords：

Chronic obstructive pulmonary disease; Left heart failure; Noninvasive positive-pressure ventilation; Treatment

DOI：

10.7507/1002-0179.20150290

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Objective To investigate the effect of noninvasive positive-pressure ventilation for elderly patients with chronic obstructive pulmonary disease (COPD) combined with left heart failure. Methods A total of 152 patients (70-85 years old) diagnosed with COPD combined with left heart failure and treated in our hospital between June 2011 and January 2015 were randomly divided into trial group (noninvasive positive-pressure ventilation with routine treatment, n=76) and control group (routine treatment, n=76). Respiratory rate, heart rate, blood pressure, pH, arterial partial pressure of carbon dioxide (PaCO₂), arterial partial pressure of oxygen (PaO₂) and left ventricular ejection fraction (LVEF) were analyzed and compared between the two groups after treatment. We did t-test to analyze the difference of these indexes between the two groups statistically. Results Respiratory rate, heart rate and PaCO₂ in both of the two groups after the treatment were significantly lower than those before the treatment (P<0.001), while PaO₂ and LVEF in both of the two groups after the treatment were significantly higher than those before the treatment (P<0.001). The systolic pressure and diastolic pressure in both of the two groups after the treatment didn't differ much from those before the treatment (P>0.05). The pH value after the treatment increased only in the trial group compared with that before the treatment (P<0.05). The respiratory rate, heart rate, pH value, PaO₂, PaCO₂ and LVEF after the treatment in trial group were meliorated compared with those in the control group (P<0.05). Conclusion Treatment with noninvasive positive-pressure ventilation for elderly patients with COPD combined with left heart failure is more efficient than the routine treatment.

Citation： HEQian, HEYa-rong, CAOYu. Clinical Efficacy of Noninvasive Positive-pressure Ventilation for Elderly Patients with Chronic Obstructive Pulmonary Disease Combined with Left Heart Failure. West China Medical Journal, 2015, 30(6): 1007-1010. doi: 10.7507/1002-0179.20150290 Copy

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10.	郭连英, 张朝晖, 谢碧珍. 无创通气治疗慢性阻塞性肺疾病合并呼吸衰竭患者的护理[J]. 中国实用护理杂志, 2012, 13(13):28-29.
11.	Gonzalez-Bermejo J, Rabec C, Janssens JP, et al. Noninvasive ventilation inefficacy due to technically incompatible ventilator settings[J]. Intensive Care Med, 2013, 39(6):1154-1156.
12.	李艳玲, 李佳林, 魏云英, 等. 老年慢性阻塞性肺疾病患者症状群分析[J]. 广东医学, 2014, 35(20):3238-3241.
13.	Zhi-Cheng F, Xiang Z, Bo-Yi L, et al. Comparative study of anti-sympathetic activity of dexmedetomidine and metoprolol in acute left heart failure patients[J]. J Clin Anesthesiol, 2013, 29(11):1079-1081.
14.	吴春风, 王笑英, 干泳华, 等. 无创通气对老年慢性阻塞性肺疾病急性加重期合并慢性左心衰竭患者心肺功能的影响[J]. 中国老年学杂志, 2013, 33(24):6109-6110.
15.	牟雄能, 郑春连. 无创正压通气在急性心肌梗死合并左心衰竭临床急救中的应用效果[J]. 中国急救医学, 2012, 32(11):1051-1053.
16.	Buss G, Mosimann PJ, Moix PA, et al. Acute right and left heart failure caused by an intrathoracic stomach[J]. Am J Emerg Med, 2012, 30(8):1658.e1-1658.e3.
17.	Seemungal TA, Donaldson GC, Bhowmik A, et al. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med, 2000, 161(5):1608-1613.
18.	Luo J, Wang MY, Zhu H, et al. Can non-invasive positive pressure ventilation prevent endotracheal intubation in acute lung injury/acute respiratory distress syndrome? A meta-analysis[J]. Respirology, 2014, 19(8):1149-1157.

1. Piazza G, Goldhaber SZ, Kroll A, et al. Venous thromboembolism in patients with chronic obstructive pulmonary disease[J]. Am J Med, 2012, 125(10):1010-1018.
2. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南(2013年修订版)[J]. 中国医学前沿杂志:电子版, 2014, 36(2):67-80.
3. 刘红菊, 吴小侠. 无创呼吸机治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的护理观察[J]. 实用临床医药杂志, 2012, 16(16):41-42.
4. Decramer M, Janssens W, Miravitlles M. Chronic obstructive pulmonary disease[J]. Lancet, 2012, 379(9823):1341-1351.
5. Falola M. Chronic obstructive pulmonary disease as a cardiovascular risk factor:results of a case-control study (CONSISTE study)[J]. Int J Chron Obstruct Pulmon Dis, 2013, 8(6):105.
6. 林志国. 无创正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者的疗效[J]. 中国老年学杂志, 2012, 32(3):621-622.
7. 刘烨. 无创呼吸机在慢性阻塞性肺病合并左心衰竭高龄患者中的应用价值[J]. 中国老年学杂志, 2014, 34(17):4855-4857.
8. Shrikrishna D, Hopkinson NS. Chronic obstructive pulmonary disease:consequences beyond the lung[J]. Clin Med, 2012, 12(1):71-74.
9. 邓剑英, 曾义菊, 王太丽. 益气活血化瘀汤治疗慢性阻塞性肺疾病急性加重期[J]. 中国实验方剂学杂志, 2014, 20(22):193-196.
10. 郭连英, 张朝晖, 谢碧珍. 无创通气治疗慢性阻塞性肺疾病合并呼吸衰竭患者的护理[J]. 中国实用护理杂志, 2012, 13(13):28-29.
11. Gonzalez-Bermejo J, Rabec C, Janssens JP, et al. Noninvasive ventilation inefficacy due to technically incompatible ventilator settings[J]. Intensive Care Med, 2013, 39(6):1154-1156.
12. 李艳玲, 李佳林, 魏云英, 等. 老年慢性阻塞性肺疾病患者症状群分析[J]. 广东医学, 2014, 35(20):3238-3241.
13. Zhi-Cheng F, Xiang Z, Bo-Yi L, et al. Comparative study of anti-sympathetic activity of dexmedetomidine and metoprolol in acute left heart failure patients[J]. J Clin Anesthesiol, 2013, 29(11):1079-1081.
14. 吴春风, 王笑英, 干泳华, 等. 无创通气对老年慢性阻塞性肺疾病急性加重期合并慢性左心衰竭患者心肺功能的影响[J]. 中国老年学杂志, 2013, 33(24):6109-6110.
15. 牟雄能, 郑春连. 无创正压通气在急性心肌梗死合并左心衰竭临床急救中的应用效果[J]. 中国急救医学, 2012, 32(11):1051-1053.
16. Buss G, Mosimann PJ, Moix PA, et al. Acute right and left heart failure caused by an intrathoracic stomach[J]. Am J Emerg Med, 2012, 30(8):1658.e1-1658.e3.
17. Seemungal TA, Donaldson GC, Bhowmik A, et al. Time course and recovery of exacerbations in patients with chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med, 2000, 161(5):1608-1613.
18. Luo J, Wang MY, Zhu H, et al. Can non-invasive positive pressure ventilation prevent endotracheal intubation in acute lung injury/acute respiratory distress syndrome? A meta-analysis[J]. Respirology, 2014, 19(8):1149-1157.

West China Medical Journal

Clinical Efficacy of Noninvasive Positive-pressure Ventilation for Elderly Patients with Chronic Obstructive Pulmonary Disease Combined with Left Heart Failure

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