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Observation on the Effect of Non-Invasive Ventilator Combined with Conventional Therapy in the Treatment of Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure
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作者 Cheng Shi 《Journal of Clinical and Nursing Research》 2024年第2期104-110,共7页
Objective:To explore the clinical effect of a non-invasive ventilator combined with conventional therapy in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure.M... Objective:To explore the clinical effect of a non-invasive ventilator combined with conventional therapy in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:68 patients with COPD combined with respiratory failure treated in our hospital from September 2021 to October 2023 were selected as the research subjects.Using the random number table method,they were divided into a control group and an experimental group of 34 cases each.The control group received conventional symptomatic treatment,and the experimental group received non-invasive ventilator treatment based on the control group.The clinical effects,blood gas indicators(partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))),lung function(forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),6 min walking distance),complications,and inflammatory factor levels(c-reactive protein(CRP),interleukin-6(IL-6),neutrophil-to-lymphocyte ratio(NLR))of the two groups of patients were observed.Results:(1)The clinical efficacy of the patients in the experimental group(33/97.06%)was more significant as compared with the control group(25/73.53%)(P<0.05);(2)After treatment,the clinical efficacy of the two groups of patients in terms of FEV1,FEV1/FVC,6-minute walking distance,PaO_(2)and SaO_(2)all increased in the experimental group as compared to that of the control group(P<0.05);(3)After treatment,the PaCO_(2),CRP,IL-6,and NLR of the two groups of patients decreased,and the decrease in the experimental group was higher than that of the control group(P<0.05);(4)The patients’complication rate in the experimental group(2/5.88%)was lower as compared to that of the control group(9/26.46%)(P<0.05).Conclusion:Non-invasive ventilators combined with conventional therapy achieved good clinical results in treating patients with COPD and respiratory failure. 展开更多
关键词 Non-invasive ventilator Conventional therapy Chronic obstructive pulmonary disease respiratory failure Clinical effect
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Clinical Study on Respiratory Medicine Treatment of Chronic Obstructive Pulmonary Disease Combined with Respiratory Failure
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作者 Jianhua Yu 《Journal of Clinical and Nursing Research》 2024年第5期293-298,共6页
Objective:To explore the respiratory medicine treatment methods for treating chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:70 cases of COPD patients with combined respiratory fai... Objective:To explore the respiratory medicine treatment methods for treating chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:70 cases of COPD patients with combined respiratory failure admitted to our hospital from January 2021 to January 2023 were selected as the study subjects,and randomly divided into the control group and the experimental group,each with 35 cases.The control group received only conventional treatment,and the experimental group received non-invasive positive pressure ventilation,and the treatment effects and changes in the levels of IL-18,hs-CRP,and CES2 inflammatory factors were observed and evaluated in the two groups.Results:There was no significant difference between the general data of the two groups(P>0.05);after treatment,the total effective rate of clinical efficacy of the observation group(91.43%)was significantly higher than that of the control group(71.43%),and the difference showed a significant correlation(P<0.05);after treatment,the level of inflammatory factor of the observation group was significantly reduced compared with that of the control group,and the difference showed a highly significant correlation(P<0.001).Conclusion:The non-invasive positive pressure ventilation treatment program significantly improves the therapeutic effect,effectively controls the level of inflammatory factors,and improves the health status of patients when dealing with patients with chronic obstructive pulmonary disease accompanied by respiratory failure,showing a good clinical application prospect. 展开更多
关键词 Chronic obstructive pulmonary disease respiratory failure Non-invasive positive pressure ventilation Therapeutic effect Inflammatory factor
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Clinical evaluation of ventilation mode on acute exacerbation of chronic obstructive pulmonary disease with respiratory failure 被引量:2
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作者 Jun-Jun Wang Zhong Zhou Li-Ying Zhang 《World Journal of Clinical Cases》 SCIE 2023年第26期6040-6050,共11页
BACKGROUND At present,understanding of the most effective ventilation methods for treating chronic obstructive pulmonary disease(COPD)patients experiencing acute worsening symptoms and respiratory failure remains rela... BACKGROUND At present,understanding of the most effective ventilation methods for treating chronic obstructive pulmonary disease(COPD)patients experiencing acute worsening symptoms and respiratory failure remains relatively limited.This report analyzed the efficiency and side effects of various ventilation techniques used for individuals experiencing an acute COPD exacerbation.AIM To determine whether pressure-controlled ventilation(PCV)can lower peak airway pressures(PAPs)and reduce the incidence of barotrauma compared to volume-controlled ventilation(VCV),without compromising clinical outcomes and oxygenation parameters.METHODS We have evaluated 600 patients who were hospitalized due to a severe COPD exacerbation,with 400 receiving mechanical ventilation for the respiratory failure.The participants were divided into two different groups,who were administered either VCV or PCV,along with appropriate management.We thereafter observed patients'attributes,clinical factors,and laboratory,radiographic,and arterial blood gas evaluations at the start and during their stay in the intensive care unit(ICU).We have also employed appropriate statistical methods for the data analysis.RESULTS Both the VCV and PCV groups experienced significant enhancements in the respiratory rate,tidal volume,and arterial blood gas values during their time in the ICU.However,no significant distinctions were detected between the groups in terms of oxygenation indices(partial pressures of oxygen/raction of inspired oxygen ratio)and partial pressures of carbon dioxide improvements.There was no considerable disparity observed between the VCV and PCV groups in the hospital mortality(32%vs 28%,P=0.53),the number of days of ICU stay[median interquartile range(IQR):9(6-14)d vs 8(5-13)d,P=0.41],or the duration of the mechanical ventilation[median(IQR):6(4-10)d vs 5(3-9)d,P=0.47].The PCV group displayed lower PAPs compared to the VCV group(P<0.05)from the beginning of mechanical ventilation until extubation or ICU departure.The occurrence of barotrauma was considerably lower in the PCV group in comparison to the VCV group(6%vs 16%,P=0.03).CONCLUSION Both VCV and PCV were found to be effective in treating patients with acute COPD exacerbation.However,PCV was associated with lower PAPs and a significant decrease in barotrauma,thus indicating that it might be a safer ventilation method for this group of patients.However,further large-scale study is necessary to confirm these findings and to identify the best ventilation approach for patients experiencing an acute COPD exacerbation. 展开更多
关键词 Chronic obstructive pulmonary disease mechanical ventilation Volume-controlled ventilation Pressurecontrolled ventilation BAROTRAUMA respiratory failure
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Clinical Analysis of Early Noninvasive Mechanical Ventilation in the Treatment of Acute Left Heart Failure Complicated with Respiratory Failure 被引量:5
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作者 Ting SUN Tianfu GONG +2 位作者 Qianhui SUN Jian ZHANG Jiaming CAO 《国际感染病学(电子版)》 CAS 2019年第2期5-7,共3页
Objective To evaluate the efficacy of early and non-early non-invasive mechanical ventilation(NIV) for acute left heart failure and respiratory failure. Methods 29 cases of patients with acute left heart failure and r... Objective To evaluate the efficacy of early and non-early non-invasive mechanical ventilation(NIV) for acute left heart failure and respiratory failure. Methods 29 cases of patients with acute left heart failure and respiratory failure treated by NIV were selected from our department from August 2016 to March 2019. According to the time of initiation of noninvasive mechanical ventilation, the patients were divided into the early treatment group(group A, treatment with NIV immediately after admission, n=15) and the non-early treatment group(group B, treatment with NIV for 2 h after admission, n=14), the improvement time, mechanical ventilation time, effective rate, intubation rate and fatality rate were compared between the two groups. Results The improvement time of patients in group A was(4.8±2.5) hours, the time of mechanical ventilation was(9.6±3.2) hours, the improvement time of group B was(6.8±2.6) hours, and the time of mechanical ventilation(12.8±4.4) hours. There were significant differences between the two groups(P<0.05). In group A, 13 patients were cured, 2 patients were intubated, 1 patient died, 10 patients in group B were cured, 4 patients were intubated, and 2 patients died. The difference in cure rate, intubation rate and mortality was statistically significant(P<0.05). Conclusion The treatment of acute left heart failure and respiratory failure is effective, and early application can improve the cure rate, reduce intubation and mortality. 展开更多
关键词 LEFT VENTRICULAR failure respiratory failure mechanical ventilation
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Effect of sequential assist-control ventilation on cardio-pulmonary function and systemic inflammatory state of chronic pulmonary heart disease complicated with respiratory failure patients 被引量:2
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作者 Jiang Wang Ya-Dong Yang +1 位作者 Qiu-Fang She Yu Tang 《Journal of Hainan Medical University》 2018年第8期10-13,共4页
Objective:To discuss the effect of sequential assist-control ventilation on cardio-pulmonary function and systemic inflammatory state of chronic pulmonary heart disease complicated with respiratory failure patients.Me... Objective:To discuss the effect of sequential assist-control ventilation on cardio-pulmonary function and systemic inflammatory state of chronic pulmonary heart disease complicated with respiratory failure patients.Method: A total of 90 cases of chronic pulmonary heart disease complicated with respiratory failure patients, who were treated in our hospital between May, 2012 and Feb., 2016, were selected, and were divided into study group (n=45) and control group (n=45) based on random number table. Patients in control group were given auxiliary - control ventilation. (A/C) treatment during the whole course, while patients in study group were given A/C+BiPAP treatment. Cardio-pulmonary function and serum inflammatory factor content difference was compared inboth groups before and after operation.Results: Before treatment, difference ofcardiac function indicator, ABG level and inflammatory factor content in both groups had no statistical significance. After treatment, cardiac function indicator (PASP, RVd) levels in both groups were lower than before treatment, and EFRV levels were higher than before treatment, and changes in study group were more obvious than that in control group;ABG indicator (PaO2) levels in both groups were higher than before treatment, and PaCO2 levels werelower than before treatment, and changes in study group were more obvious than that in control group;serum inflammatory factor (hs-CRP, IL-6, TNF-α) content in both groups was lower than before treatment, and changes in study group were more obvious than that in control group.Conclusion: sequential assist-control ventilation could optimize the cardio-pulmonary function of chronic pulmonary heart disease complicated with respiratory failure patients and reduce the systemic inflammatory response. 展开更多
关键词 Chronic PULMONARY heart disease respiratory failure SEQUENTIAL assist-control ventilation Cardio-pulmonary function Inflammatory response
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A Patient with End-stage Respiratory Failure Gets Recovery from Mechanical Ventilation by Utilization of Chinese Traditional Medicine
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作者 FANG Hui PAN Hui XIAO Dang-sheng 《World Journal of Integrated Traditional and Western Medicine》 2020年第6期40-46,共7页
Ventilator-assisted ventilation and lung transplantation are the final treatments for the patients with end-stage respiratory failure.A patient,who has been diagnosed as end-stage respiratory failure and received trac... Ventilator-assisted ventilation and lung transplantation are the final treatments for the patients with end-stage respiratory failure.A patient,who has been diagnosed as end-stage respiratory failure and received tracheal intubation with mechanical ventilation,received the treatment of Chinese herbal medicine on the principle of TCM and got some recovery gradually.After two months,the patient got rid of mechanical ventilation successfully.This case implies that TCM will be an alternative treatment for the patients with the similar conditions. 展开更多
关键词 respiratory failure mechanical ventilation System biology Herbal medicine Traditional Chinese Medicine
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Sequential treatment of severe pneumonia with respiratory failure and its influence on respiratory mechanical parameters and hemodynamics 被引量:9
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作者 Bing-Yin Niu Guan Wang +2 位作者 Bin Li Gen-Shen Zhen Yi-Bing Weng 《World Journal of Clinical Cases》 SCIE 2022年第21期7314-7323,共10页
BACKGROUND The pathophysiological characteristics of severe pneumonia complicated by respiratory failure comprise pulmonary parenchymal changes leading to ventilation imbalance,alveolar capillary injury,pulmonary edem... BACKGROUND The pathophysiological characteristics of severe pneumonia complicated by respiratory failure comprise pulmonary parenchymal changes leading to ventilation imbalance,alveolar capillary injury,pulmonary edema,refractory hypoxemia,and reduced lung compliance.Prolonged hypoxia can cause acid-base balance disorder,peripheral circulatory failure,blood-pressure reduction,arrhythmia,and other adverse consequences.AIM To investigate sequential mechanical ventilation’s effect on severe pneumonia complicated by respiratory failure.METHODS We selected 108 patients with severe pneumonia complicated by respiratory failure who underwent mechanical ventilation between January 2018 and September 2020 at the Luhe Hospital’s Intensive Care Unit and divided them into sequential and regular groups according to a randomized trial,with each group comprising 54 patients.The sequential group received invasive and non-invasive sequential mechanical ventilation,whereas the regular group received invasive mechanical ventilation.Blood-gas parameters,hemodynamic parameters,respiratory mechanical parameters,inflammatory factors,and treatment outcomes were compared between the two groups before and after mechanical-ventilation treatment.RESULTS The arterial oxygen partial pressure and stroke volume variation values of the sequential group at 24,48,and 72 h of treatment were higher than those of the conventional group(P<0.05).The carbon dioxide partial pressure value of the sequential group at 72 h of treatment and the Raw value of the treatment group at 24 and 48 h were lower than those of the conventional group(P<0.05).The pH value of the sequential group at 24 and 72 h of treatment,the central venous pressure value of the treatment at 24 h,and the Cst value of the treatment at 24 and 48 h were higher than those of the conventional group(P<0.05).The tidal volume in the sequential group at 24 h of treatment was higher than that in the conventional group(P<0.05),the measured values of interleukin-6 and tumor necrosis factor-αin the sequential group at 72 h of treatment were lower than those in the conventional group(P<0.05),and the total time of mechanical ventilation in the sequential group was shorter than that in the conventional group,with a statistically significant difference(P<0.05).CONCLUSION Treating severe pneumonia complicated by respiratory failure with sequential mechanical ventilation is more effective in improving respiratory system compliance,reducing inflammatory response,maintaining hemodynamic stability,and improving patient blood-gas levels;however,from this study’s perspective,it cannot reduce patient mortality. 展开更多
关键词 Sequential treatment mechanical ventilation Severe pneumonia respiratory failure COMPLIANCE
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Application of fiberoptic bronchscopy in patients with acute exacerbations of chronic obstructive pulmonary disease during sequential weaning of invasive-noninvasive mechanical ventilation 被引量:17
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作者 Rong-rong Song Yan-ping Qiu +1 位作者 Yong-ju Chen Yong Ji 《World Journal of Emergency Medicine》 CAS 2012年第1期29-34,共6页
BACKGROUND:Early withdrawal of invasive mechanical ventilation(IMV) followed by noninvasive MV(NIMV) is a new strategy for changing modes of treatment in patients with acute exacerbations of chronic obstructive pulmon... BACKGROUND:Early withdrawal of invasive mechanical ventilation(IMV) followed by noninvasive MV(NIMV) is a new strategy for changing modes of treatment in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD) with acute respiratory failure(ARF).Using pulmonary infection control window(PIC window) as the switch point for transferring from invasive to noninvasive MV,the time for early extubation can be more accurately judged,and therapy efficacy can be improved.This study aimed to prospectively investigate the clinical effectiveness of fiberoptic bronchscopy(FOB) in patients with AECOPD during sequential weaning of invasive-noninvasive MV.METHODS:Since July 2006 to January 2011,106 AECOPD patients with ARF were treated with comprehensive medication and IMV after hospitalization.Patients were randomly divided into two groups according to whether fiberoptic bronchoscope is used(group A,n=54) or not(group B,n=52) during sequential weaning from invasive to noninvasive MV.In group A,for sputum suction and bronchoalveolar lavage(BAL),a fiberoptic bronchoscope was put into the airway from the outside of an endotracheal tube,which was accompanied with uninterrupted use of a ventilator.After achieving PIC window,patients of both groups changed to NIMV mode,and weaned from ventilation.The following listed indices were used to compare between the groups after treatment:1) the occurrence time of PIC,the duration of MV,the length of ICU stay,the success rate of weaning from MV for the first time,the rate of reventilatJon and the occurrence rate of ventilator-associated pneumonia(VAP);2) the convenience and safety of FOB manipulation.The results were compared using Student's f test and the Chi-square test.RESULTS:The occurrence time of PIC was(5.01 ±1.49) d,(5.87±1.87) d in groups A and B,respectively(P<0.05);the duration of MV was(6.98±1.84) d,(8.69±2.41) d in groups A and B,respectively(P<0.01);the length of ICU stay was(9.25±1.84) d,(11.10±2.63) d in groups A and B,respectively(P<0.01);the success rate of weaning for the first time was 96.30%,76.92%in groups A and B,respectively(P<0.01);the rate of reventilation was 5.56%,19.23%in groups A and B,respectively(P<0.05);and the occurrence rate of VAP was 3.70%,23.07%in groups A and B,respectively(P<0.01).Moreover,it was easy and safe to manipulate FOB,and no side effect was observed.CONCLUSIONS:The application of FOB in patients with AECOPD during sequential weaning of invasive-noninvasive MV is effective in ICU.It can decrease the duration of MV and the length of ICU stay,increase the success rate from weaning MV for the first time,reduce the rate of reventilation and the occurrence rate of VAP.In addition,such a method is convenient and safe in patients of this kind. 展开更多
关键词 Acute exacerbations of chronic obstructive pulmonary disease Acute respiratory failure mechanical ventilation Sequential weaning of invasive-noninvasive ventilation Fiberoptic bronchscopy Bronchoalveolar lavage Pulmonary infection control window Side effect Success rate
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Role of diaphragmatic ultrasound in patients with acute exacerbation of chronic obstructive pulmonary disease
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作者 Prakash Banjade Yasoda Rijal +1 位作者 Munish Sharma Salim Surani 《World Journal of Clinical Cases》 SCIE 2024年第36期6887-6891,共5页
Assessing diaphragm function status is vital for diagnosing and treating acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Diaphrag-matic ultrasound has become increasingly important due to its non-i... Assessing diaphragm function status is vital for diagnosing and treating acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Diaphrag-matic ultrasound has become increasingly important due to its non-invasive nature,absence of radiation exposure,widespread availability,prompt results,high accuracy,and repeatability at the bedside.The diaphragm is a crucial respiratory muscle.Decline or dysfunction of the diaphragm can lead to dyspnea and even respiratory failure in AECOPD patients.In this editorial,we comment on an article,retrospectively analyzed ninety-four acute exacerbations of chronic obstructive pulmonary disease patients who received mechanical ventilation from January 2022 to December 2023.The study found that the diaphragm thickening fraction,an index from diaphragm ultrasound,can better predict the outcome of non-invasive ventilation in patients with AECOPD.The value of non-invasive ventilation in treating respiratory failure caused by AECOPD has been widely acknowledged.Diaphragmatic dysfunction diagnosed with ultrasound is asso-ciated with prolonged mechanical ventilation and weaning times and higher mortality. 展开更多
关键词 Diaphragm ultrasound Chronic obstructive pulmonary disease DIAPHRAGM ULTRASOUND Obstructive lung disease Nivalenol respiratory failure mechanical ventilation
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Effect of adjuvant noninvasive positive pressure ventilation on blood gas parameters, cardiac function and inflammatory state in patients with COPD and type II respiratory failure 被引量:1
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作者 You-Ming Zhu Hui Hu Ye Zeng 《Journal of Hainan Medical University》 2017年第3期44-48,共5页
Objective:T o analyze the effect of adjuvant noninvasive positive pressure ventilation on blood gas parameters, cardiac function and inflammatory state in patients with chronic obstructive pulmonary disease (COPD) and... Objective:T o analyze the effect of adjuvant noninvasive positive pressure ventilation on blood gas parameters, cardiac function and inflammatory state in patients with chronic obstructive pulmonary disease (COPD) and type II respiratory failure. Methods:90 patients with COPD and type II respiratory failure were randomly divided into observation group and control group (n=45). Control group received conventional therapy, observation group received conventional therapy+adjuvant noninvasive positive pressure ventilation, and differences in blood gas parameters, cardiac function, inflammatory state, etc., were compared between two groups of patients 2 weeks after treatment. Results:Arterial blood gas parameters pH and alveolar-arterial partial pressure of oxygen [P(A-a)O2] levels of observation group were higher than those of control group while, potassium ion (K+), chloride ion (Cl-) and carbon dioxide combining power (CO2CP) levels were lower than those of control group 2 weeks after treatment;echocardiography parameters Doppler-derived tricuspid lateral annular systolic velocity (DTIS) and pulmonary arterial velocity (PAV) levels were lower than those of control group (P<0.05) while pulmonary artery accelerating time (PAACT), left ventricular end-diastolic dimension (LVDd) and right atrioventricular tricuspid annular plane systolic excursion (TAPSE) levels were higher than those of control group (P<0.05);serum cardiac function indexes adiponectin (APN), Copeptin, N-terminal pro-B-type natriuretic peptide (NT-proBNP), cystatin C (CysC), growth differentiation factor-15 (GDF-15) and heart type fatty acid binding protein (H-FABP) content were lower than those of control group (P<0.05);serum inflammatory factors hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), IL-8, IL-10, and transforming growth factor-β1 (TGF-β1) content were lower than those of control group (P<0.05). Conclusions:Adjuvant noninvasive positive pressure ventilation can optimize the blood gas parameters, cardiac function and inflammatory state in patients with COPD and type II respiratory failure, and it is of positive significance in improving the overall treatment outcome. 展开更多
关键词 Chronic OBSTRUCTIVE PULMONARY disease Type II respiratory failure NONINVASIVE positive pressure ventilation Blood gas PARAMETERS
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Respiratory failure in diabetic ketoacidosis 被引量:2
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作者 Nikifor K Konstantinov Mark Rohrscheib +3 位作者 Emmanuel I Agaba Richard I Dorin Glen H Murata Antonios H Tzamaloukas 《World Journal of Diabetes》 SCIE CAS 2015年第8期1009-1023,共15页
Respiratory failure complicating the course of diabetic ketoacidosis(DKA)is a source of increased morbidity and mortality.Detection of respiratory failure in DKA requires focused clinical monitoring,careful interpreta... Respiratory failure complicating the course of diabetic ketoacidosis(DKA)is a source of increased morbidity and mortality.Detection of respiratory failure in DKA requires focused clinical monitoring,careful interpretation of arterial blood gases,and investigation for conditions that can affect adversely the respiration.Conditions that compromise respiratory function caused by DKA can be detected at presentation but are usually more prevalent during treatment.These conditions include deficits of potassium,magnesium and phosphate and hydrostatic or non-hydrostatic pulmonary edema.Conditions not caused by DKA that can worsen respiratory function under the added stress of DKA include infections of the respiratory system,pre-existing respiratory or neuromuscular disease and miscellaneous other conditions.Prompt recognition and management of the conditions that can lead to respiratory failure in DKA may prevent respiratory failure and improve mortality from DKA. 展开更多
关键词 Diabetic KETOACIDOSIS respiratory failure HYPOKALEMIA HYPOMAGNESEMIA HYPOPHOSPHATEMIA Pulmonary edema Adult respiratory distress syndrome Pneumonia neuromuscular disease
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Respiratory evaluation of patients requiring ventilator support due to acute respiratory failure 被引量:2
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作者 Carmen Silvia Valente Barbas Giovana Caroline Lopes +3 位作者 Debora Feijo Vieira Lara Poletto Couto Leticia Kawano Dourado Eliana Caser 《Open Journal of Nursing》 2012年第3期336-340,共5页
This review, based on relevant published evidence and the authors` clinical experience, presents how to evaluate a patient with acute respiratory failure requiring ventilatory support. This patient must be carefully e... This review, based on relevant published evidence and the authors` clinical experience, presents how to evaluate a patient with acute respiratory failure requiring ventilatory support. This patient must be carefully evaluated by nurses, physiotherapists, respiratory care practitioners and physicians regarding the elucidation of the cause of the acute episode of respiratory failure by means of physical examination with the measurement of respiratory parameters and assessment of arterial blood gases analysis to make a correct respiratory diagnosis. After the initial evaluation, the patient must quickly receive adequate oxygen and ventilatory support that has to be carefully monitored until its discontinuation. When available, a noninvasive ventilation trial must be done in patients presenting desaturation during oxygen mask and or PaCO2 retention, especially in cases of cardiogenic pulmonary edema and severe exacerbation of chronic obstructive pulmonary disease. In cases of noninvasive ventilation trial-failure, endotracheal intubation and invasive protective mechanical ventilation must be promptly initiated. In severe ARDS patients, low tidal ventilation, higher PEEP levels, prone positioning and recruitment maneuvers with adequate PEEP titration should be used. Recently, new modes of ventilation should allow a better patient-ventilator interaction or synchrony permitting a sufficient unloading of respiratory muscles and increase patient comfort. Patients with chronic obstructive pulmonary disease may be considered for a trial for early extubation to noninvasive positive pressure ventilation in centers with extensive experience in noninvasive positive pressure ventilation. 展开更多
关键词 respiratory failure Noninvasive ventilation Endotracheal Intubation Invasive mechanical ventilation Patient-Ventilator Synchrony
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苏子降气汤结合机械通气治疗慢性阻塞性肺疾病伴呼吸衰竭临床研究 被引量:1
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作者 邱彬 江煜佳 《新中医》 CAS 2024年第5期11-15,共5页
目的:观察苏子降气汤结合机械通气治疗慢性阻塞性肺疾病伴呼吸衰竭的临床疗效。方法:选择82例慢性阻塞性肺疾病伴呼吸衰竭患者作为研究对象,采用随机数字表法分为对照组和观察组各41例。在支持治疗的基础上,对照组给予机械通气治疗,观... 目的:观察苏子降气汤结合机械通气治疗慢性阻塞性肺疾病伴呼吸衰竭的临床疗效。方法:选择82例慢性阻塞性肺疾病伴呼吸衰竭患者作为研究对象,采用随机数字表法分为对照组和观察组各41例。在支持治疗的基础上,对照组给予机械通气治疗,观察组给予苏子降气汤结合机械通气治疗。评价2组临床疗效,比较2组治疗前后生命体征、肺功能指标及炎症因子水平。结果:观察组总有效率为97.56%,高于对照组85.37%(P<0.05)。治疗后,2组呼吸频率、心率较治疗前降低(P<0.05),且观察组体温、呼吸频率、心率低于对照组(P<0.05)。治疗后,2组第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC较治疗前升高(P<0.05),且观察组FEV_(1)、FVC、FEV_(1)/FVC高于对照组(P<0.05)。治疗后,2组降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)水平较治疗前降低(P<0.05),且观察组PCT、TNF-α、IL-4水平低于对照组(P<0.05)。结论:苏子降气汤结合机械通气治疗慢性阻塞性肺疾病伴呼吸衰竭患者,可提高临床疗效,改善患者生命体征,提高肺功能,缓解炎症反应。 展开更多
关键词 慢性阻塞性肺疾病 苏子降气汤 机械通气 呼吸衰竭 肺功能 炎症因子
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无创机械通气联合呼吸训练在AECOPD合并呼吸衰竭患者中的应用评价
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作者 叶宁 罗淼 +1 位作者 秦燕 唐丽娟 《中国医学创新》 CAS 2024年第6期27-31,共5页
目的:探讨无创机械通气联合呼吸训练对慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭患者的效果。方法:前瞻性纳入2019年2月—2022年2月桂林医学院附属医院急诊科收治的AECOPD合并呼吸衰竭患者共67例,采用随机数字表法将患者分为两... 目的:探讨无创机械通气联合呼吸训练对慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸衰竭患者的效果。方法:前瞻性纳入2019年2月—2022年2月桂林医学院附属医院急诊科收治的AECOPD合并呼吸衰竭患者共67例,采用随机数字表法将患者分为两组。对照组(n=33)接受间断无创机械通气治疗,观察组(n=34)在对照组基础上增加主动呼吸训练(包括上肢弹力带阻抗训练、缩唇腹式呼吸、呼吸训练器使用)。记录两组2 d内撤机成功率、不良反应发生率,比较两组氧合指数(OI)、动脉血二氧化碳分压(PaCO_(2))、改良版英国医学研究委员会(mMRC)呼吸困难问卷分级、呼吸频率(RR)、自主呼吸潮气量。结果:对照组2 d内撤机成功率为60.6%,观察组为82.4%,观察组的撤机成功率高于对照组(P<0.05);观察组咳痰乏力、呼吸疲劳发生率均低于对照组(P<0.05);与治疗前相比,两组患者治疗2 d后的OI和PaCO_(2)均有显著改善,差异均有统计学意义(P<0.05);治疗2 d后,观察组PaCO_(2)低于对照组(P<0.05),但两组OI比较,差异无统计学意义(P>0.05);与治疗前相比,两组患者治疗2 d后的mMRC呼吸困难问卷分级和RR均有明显下降,自主呼吸潮气量均有明显提升,差异均有统计学意义(P<0.05);治疗2 d后,两组mMRC呼吸困难问卷分级和RR比较,差异均无统计学意义(P>0.05),但观察组患者自主呼吸潮气量明显高于对照组(P<0.05)。结论:AECOPD合并呼吸衰竭患者进行无创机械通气联合呼吸训练,能有效改善呼吸肌疲劳,增加肺通气,提高撤机成功率。 展开更多
关键词 无创机械通气 呼吸训练 慢性阻塞性肺疾病急性加重期 呼吸衰竭
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适应性支持通气对COPD并发呼吸衰竭患者肺损伤及撤机成功率的影响
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作者 刘彬彬 贺志力 吴英萍 《中国医学创新》 CAS 2024年第14期53-57,共5页
目的:观察适应性支持通气对慢性阻塞性肺疾病(COPD)并发呼吸衰竭患者肺损伤及撤机成功率的影响。方法:选取南昌市洪都中医院2020年8月—2023年8月收治的80例行机械通气治疗的COPD并发呼吸衰竭患者为对象,按随机数字表法分为A组(适应性... 目的:观察适应性支持通气对慢性阻塞性肺疾病(COPD)并发呼吸衰竭患者肺损伤及撤机成功率的影响。方法:选取南昌市洪都中医院2020年8月—2023年8月收治的80例行机械通气治疗的COPD并发呼吸衰竭患者为对象,按随机数字表法分为A组(适应性支持通气模式)、B组(同步间歇指令+压力支持通气模式),各40例。比较两组血气指标、呼吸功能、急性生理与慢性健康状况评价Ⅱ(APACHEⅡ)评分、不良事件及撤机情况。结果:治疗后,两组动脉氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、酸碱度(pH值)、APACHEⅡ评分比较,差异均无统计学意义(P>0.05)。A组一次性撤机成功率、达峰时间比(TPTEF/TE)、达峰容积比(VPEF/VE)均高于B组,吸呼比(TI/TE)、呼吸频率(RR)均低于B组,差异均有统计学意义(P<0.05)。两组治疗期间不良事件发生率比较,差异无统计学意义(P>0.05)。结论:适应性支持通气用于COPD并发呼吸衰竭患者能更好地改善呼吸功能,提高一次性撤机成功率。 展开更多
关键词 适应性支持通气 慢性阻塞性肺疾病 呼吸衰竭
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序贯机械通气在重症肺炎合并呼吸衰竭中的应用及对患者血流动力学的影响
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作者 王方 李丽 姜相东 《当代医学》 2024年第9期11-15,共5页
目的探讨序贯机械通气在重症肺炎合并呼吸衰竭中的应用及对患者血流动力学的影响。方法选取2019年1月至2022年3月中国人民解放军联勤保障部队第967医院收治的78例重症肺炎合并呼吸衰竭患者作为研究对象,根据治疗方法不同分为对照组与研... 目的探讨序贯机械通气在重症肺炎合并呼吸衰竭中的应用及对患者血流动力学的影响。方法选取2019年1月至2022年3月中国人民解放军联勤保障部队第967医院收治的78例重症肺炎合并呼吸衰竭患者作为研究对象,根据治疗方法不同分为对照组与研究组,每组39例。对照组行常规有创机械通气,研究组行序贯机械通气,比较两组机械通气治疗相关指标、住院时间、血气指标、炎症因子水平、心肌损伤指标、血流动力学指标及并发症发生情况。结果研究组有创通气时间、机械通气总时间及住院时间均短于对照组,差异有统计学意义(P<0.05);治疗后,两组动脉血氧分压(PaO2)、碳酸氢根(HCO3-)水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组氨基末端脑钠尿肽(NT-proBNP)水平及研究组肌钙蛋白I(cTnI)水平均低于治疗前,对照组cTnI水平高于治疗前,且研究组cTnI、NT-proBNP水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组心率(HR)、呼吸频率(RR)均慢于治疗前,收缩压(SBP)均低于治疗前,且研究组HR、RR均慢于对照组,SBP低于对照组,差异有统计学意义(P<0.05)。研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论序贯机械通气治疗重症肺炎合并呼吸衰竭疗效显著,可缩短住院时间,有效改善患者炎症反应、心肌损伤指标及血流动力学指标,且安全性较高。 展开更多
关键词 重症肺炎 呼吸衰竭 序贯机械通气 血流动力学
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俯卧位机械通气对重症肺炎合并呼吸衰竭患者血气分析指标及疾病好转情况的影响
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作者 王方 李丽 姜相东 《当代医学》 2024年第5期54-58,共5页
目的探究俯卧位机械通气对重症肺炎合并呼吸衰竭患者血气分析指标及疾病好转情况的影响。方法选取2018年6月至2021年6月中国人民解放军联勤保障部队第九六七医院接诊的82例重症肺炎合并呼吸衰竭患者作为研究对象,按照随机抽签法分为对... 目的探究俯卧位机械通气对重症肺炎合并呼吸衰竭患者血气分析指标及疾病好转情况的影响。方法选取2018年6月至2021年6月中国人民解放军联勤保障部队第九六七医院接诊的82例重症肺炎合并呼吸衰竭患者作为研究对象,按照随机抽签法分为对照组与观察组,每组41例。两组均行常规对症治疗,对照组辅以仰卧位机械通气,观察组辅以俯卧位机械通气。比较两组疾病好转率、干预前后血气指标、机械通气时间及住院时间、并发症发生情况及干预前后急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分。结果干预7 d后,观察组疾病好转率高于对照组,差异有统计学意义(P<0.05)。干预7 d后,两组血液pH、血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))水平均高于干预前,动脉血二氧化碳分压(PaCO_(2))均低于干预前,且观察组血液pH、SaO_(2)、PaO_(2)高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。观察组机械通气时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义。干预7 d后,两组APACHE-Ⅱ评分均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论俯卧位机械通气可提高重症肺炎呼吸衰竭患者疾病好转率,减轻病情严重程度,改善血气指标,缩短机械通气时间、住院时间,使其早日康复出院。 展开更多
关键词 重症肺炎合并呼吸衰竭 俯卧位 机械通气 血气分析 疾病好转情况
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机械通气对ICU重症心力衰竭患者呼吸循环及心功能的影响
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作者 张玲梅 林秀明 周晓 《中国医药指南》 2024年第4期93-95,共3页
目的探讨机械通气在重症监护室(ICU)重症心力衰竭临床治疗中的应用效果,结合患者的呼吸循环及心功能恢复情况进行评价。方法选取我院2020年2月至2023年6月收治的ICU重症心力衰竭患者84例作为研究对象,随机分为观察组(机械通气+常规治疗... 目的探讨机械通气在重症监护室(ICU)重症心力衰竭临床治疗中的应用效果,结合患者的呼吸循环及心功能恢复情况进行评价。方法选取我院2020年2月至2023年6月收治的ICU重症心力衰竭患者84例作为研究对象,随机分为观察组(机械通气+常规治疗)和对照组(常规治疗)各42例,对比两组患者的呼吸循环功能、心功能及并发症发生情况。结果治疗后,观察组呼吸频率、PaCO_(2)低于对照组,氧合指数、PaO_(2)高于对照组(P<0.05)。观察组LVEF高于对照组,LVESV、LVEDV、NT-proBNP、CK-MB低于对照组(P<0.05)。观察组并发症发生率低于对照组(4.8%vs.21.4%,P=0.024)。结论在ICU重症心力衰竭患者的临床治疗中,实施机械通气治疗,在改善呼吸循环、促进心功能恢复等方面具有良好的效果。 展开更多
关键词 机械通气 重症监护室 重症心力衰竭 呼吸循环 心功能
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基于血清iNOS和eNOS水平建立慢性阻塞性肺疾病急性加重患者机械通气撤机预测模型
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作者 郭志强 刘云峰 +2 位作者 高晓玲 李润杰 赵立春 《中国急救医学》 CAS CSCD 2024年第7期593-597,共5页
目的 基于血清诱导型一氧化氮合酶(iNOS)和内皮型一氧化氮合酶(eNOS)水平建立慢性阻塞性肺疾病急性加重(AECOPD)患者机械通气撤机的预测模型。方法 选择2020年1月至2023年6月在河北北方学院附属第一医院接受机械通气治疗的166例AECOPD患... 目的 基于血清诱导型一氧化氮合酶(iNOS)和内皮型一氧化氮合酶(eNOS)水平建立慢性阻塞性肺疾病急性加重(AECOPD)患者机械通气撤机的预测模型。方法 选择2020年1月至2023年6月在河北北方学院附属第一医院接受机械通气治疗的166例AECOPD患者,按照撤机结局分为撤机成功组(n=112)和撤机失败组(n=54)。比较两组患者的临床资料及入院时、自主呼吸试验(SBT)前的血清iNOS、eNOS水平。采用Logistic回归分析撤机失败的影响因素,采用受试者工作特征(ROC)曲线分析iNOS、eNOS预测撤机失败的价值。结果 与撤机成功组比较,撤机失败组SBT前24 h内的急性生理学与慢性健康状况评价Ⅱ(APACHEⅡ)评分、肌酐(Cr)、iNOS、eNOS水平较高,白蛋白(Alb)水平较低(P<0.05);多因素Logistic回归分析显示,APACHEⅡ、Alb、iNOS、eNOS是撤机失败的影响因素(P<0.05);ROC曲线分析显示,iNOS、eNOS预测撤机失败的ROC曲线下面积为0.648(95%CI 0.563~0.733,P=0.002)、0.755(95%CI 0.683~0.827,P<0.001),以4.418 ng/mL、3.821 ng/mL为最佳截断值,预测敏感度分别为68.52%、83.33%,特异度分别为51.82%、66.36%;iNOS、eNOS与Alb、APACHEⅡ联合预测撤机失败的ROC曲线下面积为0.961(95%CI 0.928~0.993),优于单一指标(Z=7.412、6.682、4.323、4.951,P<0.05),敏感度和特异度分别为94.44%和90.91%。结论 AECOPD患者SBT前血清iNOS、eNOS水平增加与撤机失败相关,SBT前检测iNOS、eNOS联合Alb、APACHEⅡ能够较好地预测撤机结局。 展开更多
关键词 慢性阻塞性肺疾病急性加重 机械通气 撤机失败 诱导型一氧化氮合酶
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危重症专职护理联合改良式体位管理在慢性阻塞性肺疾病呼吸衰竭机械通气患者中的应用
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作者 宗海燕 赵继庆 +1 位作者 蔡克 郭静 《中国当代医药》 CAS 2024年第12期167-170,共4页
目的探讨危重症专职护理联合改良式体位管理在慢性阻塞性肺疾病呼吸衰竭(RF)机械通气(MV)患者中的应用效果。方法选取2021年1月至2023年1月九江市第一人民医院收治的61例慢性阻塞性肺疾病RF患者作为研究对象,按照随机数字表法分为对照组... 目的探讨危重症专职护理联合改良式体位管理在慢性阻塞性肺疾病呼吸衰竭(RF)机械通气(MV)患者中的应用效果。方法选取2021年1月至2023年1月九江市第一人民医院收治的61例慢性阻塞性肺疾病RF患者作为研究对象,按照随机数字表法分为对照组(30例)和观察组(31例)。对照组患者采用危重症专职护理,观察组患者采用危重症专职护理联合改良式体位管理。比较两组患者的心功能、血气指标、临床指标、并发症发生率和呼吸机相关性肺炎(VAP)发生率。结果两组患者护理前的左室射血分数(LVEF)、第1秒用力呼气容积(FEV1)、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))比较,差异无统计学意义(P>0.05)。两组护理后的LVEF、FEV1、PaO_(2)均高于本组护理前,PaCO_(2)均低于本组护理前,差异有统计学意义(P<0.05);观察组护理后的LVEF、FEV1、PaO_(2)均高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。观察组的机械通气时间、ICU入住时间和住院时间均短于对照组,VAP发生率和并发症发生率均低于对照组,差异有统计学意义(P<0.05)。结论在行MV治疗的慢性阻塞性肺疾病RF患者中应用危重症专职护理联合改良式体位管理可改善心功能及血气指标,缩短机械通气、ICU入住及住院时间,降低并发症及VAP发生率,值得推广。 展开更多
关键词 慢性阻塞性肺疾病 呼吸衰竭 机械通气 危重症专职护理 改良式体位管理
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