Objective To study the clinical feasibility of invasive mechanical ventilation with bilevel positive airway pressure(BiPAP) non-invasive ventilator in the stable patients needing prolonged mechanical ventilation.Methods Eleven patients with respiratory failure admitted in intensive care unit(ICU)of our department,who needed prolonged mechanical ventilation,between Jun 2004 and Nov 2007 were enrolled in the study and followed until death or Jan 2008.The arterial blood gas analysis data,length of stay(LOS),LOS after changing to BiPAP non-invasive ventilator(Synchrony,Harmony,RESPIRONICS,VPAP III ST-A,RESMED),survival time after discharge(or fulfilled the discharge standards) were reviewed retrospectively.Results The settings of inspiratory pressure,expiratory pressure and respiratory rate of non-invasive ventilation were 21.3 (16-26) cm H2O,4 cm H2O,and 16 min-1,respectively.The LOS (or up to the discharge standard) was (91.5±50.2) days.The LOS (or up to the discharge standard) after changing to BiPAP ventilator was (23.5±12.2) days.The mean survival time after discharge (or up to the discharge standard) was (353.1±296.5) days.Four patients were still alive up to the end of the study.The arterial pH,PaCO2,PaO2,and SaO2 were not significant different before and after changing to BiPAP ventilator.Conclusion The mechanical ventilation with BiPAP non-invasive ventilator via tracheotomy tube is an alternative choice for stable patients needing prolonged mechanical ventilation.
ObjectiveTo observe the clinical curative effect of bilevel positive airway pressure (BiPAP) noninvasive ventilator in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure. MethodsThe clinical materials of 80 patients with AECOPD with respiratory failure were reviewed and analyzed from January 2010 to December 2012. The patients were divided into two groups based on whether BiPAP mechanical ventilation therapy was implemented or not. The vital signs and arterial blood gas analysis, curative effect and medical expenses were compared between the two groups. ResultsThe indexes of vital signs and blood gas analysis before and after treatment showed the consistency of the trend of gradual improvement (P<0.05). After 3-day treatment, the indexes of vital signs and blood gas analysis in the study group were significantly better than the control group (P<0.05). Compared with the control group, the total effective rate was significantly higher, the hospital stay was significantly shorter, the intubation was significantly less, and the medical expenses were significantly lower in the study group (P<0.05). ConclusionThe BiPAP non-invasive ventilator has significant effect in improving vital sign, index of blood gas analysis, rate of endotracheal intubation and length of stay, which is worthy of further promotion.