Original Article
Optimal switch timing of invasive-noninvasive sequential ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease
Zhao Yuliang, Liu Yawen, Zhao Yun, Shi Weitao, Li Zhihai, Shi Yingjun
Published 2019-10-25
Cite as Chin J Pract Med, 2019,46(20): 10-13. DOI: 10.3760/cma.j.issn.1674-4756.2019.20.003
Abstract
ObjectiveTo investigate the optimal switch timing of invasive-noninvasive sequential ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).
MethodsA total of 60 AECOPD patients admitted to the First People’s Hospital of Xuzhou from August 2016 to January 2018 were selected. The patients were divided into the control group and the observation group according to the random envelope method, with 30 cases in each group. In the control group, the conventional infection control window was used as the sequential mechanical ventilation switch point. While in observation group, the modified infection control window was used as seguential ventilation switch point. The ventilator pneumonia (VAP), re-intubation/reaching re-intubation level and related indicators were compared between the two groups.
ResultsThe incidence of VAP in the observation group was 6.67% (2/30), and that in the control group was 26.67% (8/30). The incidence of VAP was lower in the observation group than that in the control group (χ2=4.320, P=0.038). The incidence of re-intubation/ reaching re-intubation level in the observation group was 10.00% (3/30), which was lower than 13.33% (4/30) in the control group (χ2=0.162, P=0.688). The invasive ventilation time, total ventilation time, and intensive care unit hospitalization time in the observation group were lower than those in the control group (t=9.159, 3.506, 6.322; P=0.000, 0.001, 0.000). The in-hospital fatality rate of the observation group was 0, which was lower than that of the control group (χ2=4.286, P=0.038).
ConclusionsThe improved infection control window combined with auxiliary indexes in judging the switch timing of sequential ventilation can reduce the incidence of VAP and complications, shorten the time of invasive ventilation, total ventilation time and ICU hospitalization time, and reduce the on-line success rate.
Key words:
Acute exacterbation of chronic obstructive pulmonary disease; Invasive-noninvasive seguential ventilation; Infection controt window
Contributor Information
Zhao Yuliang
Department of Critical Care Medicine, Xuzhou First People’s Hospital, Xuzhou 221002, China
Liu Yawen
Department of Critical Care Medicine, Xuzhou First People’s Hospital, Xuzhou 221002, China
Zhao Yun
Department of Critical Care Medicine, Xuzhou First People’s Hospital, Xuzhou 221002, China
Shi Weitao
Department of Critical Care Medicine, Xuzhou First People’s Hospital, Xuzhou 221002, China
Li Zhihai
Department of Critical Care Medicine, Xuzhou First People’s Hospital, Xuzhou 221002, China
Shi Yingjun
Department of Critical Care Medicine, Xuzhou First People’s Hospital, Xuzhou 221002, China
