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

Video：

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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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7.	劉燁. 無創呼吸機在慢性阻塞性肺病合并左心衰竭高齡患者中的應用價值[J]. 中國老年學雜志, 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.	鄧劍英, 曾義菊, 王太麗. 益氣活血化瘀湯治療慢性阻塞性肺疾病急性加重期[J]. 中國實驗方劑學雜志, 2014, 20(22):193-196.
10.	郭連英, 張朝暉, 謝碧珍. 無創通氣治療慢性阻塞性肺疾病合并呼吸衰竭患者的護理[J]. 中國實用護理雜志, 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.	李艷玲, 李佳林, 魏云英, 等. 老年慢性阻塞性肺疾病患者癥狀群分析[J]. 廣東醫學, 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.	吳春風, 王笑英, 干泳華, 等. 無創通氣對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響[J]. 中國老年學雜志, 2013, 33(24):6109-6110.
15.	牟雄能, 鄭春連. 無創正壓通氣在急性心肌梗死合并左心衰竭臨床急救中的應用效果[J]. 中國急救醫學, 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. 中華醫學會呼吸病學分會慢性阻塞性肺疾病學組. 慢性阻塞性肺疾病診治指南(2013年修訂版)[J]. 中國醫學前沿雜志:電子版, 2014, 36(2):67-80.
3. 劉紅菊, 吳小俠. 無創呼吸機治療慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭的護理觀察[J]. 實用臨床醫藥雜志, 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. 林志國. 無創正壓通氣治療慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者的療效[J]. 中國老年學雜志, 2012, 32(3):621-622.
7. 劉燁. 無創呼吸機在慢性阻塞性肺病合并左心衰竭高齡患者中的應用價值[J]. 中國老年學雜志, 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. 鄧劍英, 曾義菊, 王太麗. 益氣活血化瘀湯治療慢性阻塞性肺疾病急性加重期[J]. 中國實驗方劑學雜志, 2014, 20(22):193-196.
10. 郭連英, 張朝暉, 謝碧珍. 無創通氣治療慢性阻塞性肺疾病合并呼吸衰竭患者的護理[J]. 中國實用護理雜志, 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. 李艷玲, 李佳林, 魏云英, 等. 老年慢性阻塞性肺疾病患者癥狀群分析[J]. 廣東醫學, 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. 吳春風, 王笑英, 干泳華, 等. 無創通氣對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響[J]. 中國老年學雜志, 2013, 33(24):6109-6110.
15. 牟雄能, 鄭春連. 無創正壓通氣在急性心肌梗死合并左心衰竭臨床急救中的應用效果[J]. 中國急救醫學, 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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