Clinical analysis of optimal timing for application of noninvasive positive pressure ventilation in treatment of AECOPD patients

摘要

OBJECTIVES: This study is conducted to investigate an optimal timing of sequential noninvasive positive pressure ventilation (NPPV) applied for patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). PATIENTS AND METHODS: Application of NPPV for 102 patients was randomly observed in the conditions of a 2-hour spontaneous breathing trial (SBT-2) and pulmonary infection control (PIC) window. Efficiency of NPPV in treatment of the patients, an incidence rate of tracheal reintubation, length of time for patients received invasive mechanical ventilation, and a morbidity rate of ventilator-associated pneumonia were examined in each group of 51 patients. RESULTS: The incidence rates for the patients treated successfully with NPPV and for tracheal reintubation were shown as 88.2 and 60.8, and 11.8 and 39.2 in SBT-2 and PIC, respectively (both p < 0.05). Length of time (hour) for use of the invasive ventilation was 116 and 82.5 in SBT-2 and PIC, respectively (p < 0.05). There was a similar morbidity rate of ventilator-associated pneumonia seen in both groups. CONCLUSIONS: SBT-2 would be the optimal timing considered to use NPPV for AECOPD patients based on a high success rate and a low risk of tracheal reintubation.