Analysis of the Effect of Non-Invasive Positive Pressure Ventilation in Emergency Treatment of Severe Bronchial Asthma with Respiratory Failure

Objective:This study aims to evaluate the clinical efficacy of non-invasive positive pressure ventilation(NIPPV)in patients with severe bronchial asthma combined with respiratory failure.Methods:90 patients with severe bronchial asthma combined with respiratory failure between September 2022 and December 2023 were selected for the study and randomly divided into the experimental group(NIPPV-assisted treatment)and the control group.The differences between the two groups were compared in terms of total effective rate of treatment,days of clinical symptom disappearance,days of hospitalization,lung function indexes,incidence of adverse reactions,and quality of life.Results:Patients in the experimental group had a significantly higher total effective rate of treatment(97.78%)than the control group(75.56%).In terms of pulmonary function indexes,patients in the experimental group showed significant improvement after treatment,especially the increase in forced expiratory volume and forced vital capacity,while these improvements were not as obvious in the control group.In addition,the incidence of adverse reactions was significantly lower in the experimental group than in the control group,suggesting that the application of NIPPV is relatively safe.Quality of life assessment also showed that patients in the experimental group had significantly better quality of life than the control group after treatment.Conclusion:This study demonstrated the effectiveness of NIPPV as an adjunctive treatment for severe bronchial asthma combined with respiratory failure.NIPPV can improve lung function,reduce the incidence of adverse effects,increase the overall effectiveness of the treatment,and contribute to the improvement of patients'quality of life.Therefore,NIPPV should be regarded as an effective and safe treatment in clinical management,especially in patients with severe bronchial asthma combined with respiratory failure,where its application has potential clinical significance.

Effects of pulmonary surfactant combined with noninvasive positive pressure ventilation in neonates with respiratory distress syndrome

BACKGROUND Neonatal respiratory distress syndrome(NRDS)is one of the most common diseases in neonatal intensive care units,with an incidence rate of about 7%among infants.Additionally,it is a leading cause of neonatal death in hospitals in China.The main mechanism of the disease is hypoxemia and hypercapnia caused by lack of surfactant AIM To explore the effect of pulmonary surfactant(PS)combined with noninvasive positive pressure ventilation on keratin-14(KRT-14)and endothelin-1(ET-1)levels in peripheral blood and the effectiveness in treating NRDS.METHODS Altogether 137 neonates with respiratory distress syndrome treated in our hospital from April 2019 to July 2021 were included.Of these,64 control cases were treated with noninvasive positive pressure ventilation and 73 observation cases were treated with PS combined with noninvasive positive pressure ventilation.The expression of KRT-14 and ET-1 in the two groups was compared.The deaths,complications,and PaO_(2),PaCO_(2),and PaO_(2)/FiO_(2)blood gas indexes in the two groups were compared.Receiver operating characteristic curve(ROC)analysis was used to determine the diagnostic value of KRT-14 and ET-1 in the treatment of NRDS.RESULTS The observation group had a significantly higher effectiveness rate than the control group.There was no significant difference between the two groups in terms of neonatal mortality and adverse reactions,such as bronchial dysplasia,cyanosis,and shortness of breath.After treatment,the levels of PaO_(2)and PaO_(2)/FiO_(2)in both groups were significantly higher than before treatment,while the level of PaCO_(2)was significantly lower.After treatment,the observation group had significantly higher levels of PaO_(2)and PaO_(2)/FiO_(2)than the control group,while PaCO_(2)was notably lower in the observation group.After treatment,the KRT-14 and ET-1 levels in both groups were significantly decreased compared with the pre-treatment levels.The observation group had a reduction of KRT-14 and ET-1 levels than the control group.ROC curve analysis showed that the area under the curve(AUC)of KRT-14 was 0.791,and the AUC of ET-1 was 0.816.CONCLUSION Combining PS with noninvasive positive pressure ventilation significantly improved the effectiveness of NRDS therapy.KRT-14 and ET-1 levels may have potential as therapeutic and diagnostic indicators.

Effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia

Objective: To discuss the effect of lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation on the blood gas results and systemic state of patients with COPD complicated by severe pneumonia. Methods: A total of 68 patients with COPD complicated by severe pneumonia who were treated in the hospital between November 2015 and April 2017 were collected, retrospectively analyzed and then divided into the group A (n=35) who received noninvasive positive pressure ventilation and the group B (n=33) who received lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation. The differences in arterial blood gas and serum index levels were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in arterial blood gas index levels as well as serum contents of inflammatory mediators, stress hormones and myocardial enzyme spectrum indexes between the two groups. After treatment, arterial blood gas indexes PH and PaO2 levels of group B were higher than those of group A;serum inflammatory mediators HMGB1, PCT and hs-CRP contents were lower than those of group A;serum stress hormones Cor, AngⅠ and AngⅡcontents were lower than those of group A;serum myocardial enzyme spectrum indexesα-HBDH and cTn-Ⅰ contents were lower than those of group A. Conclusion: Lung lavage via fiber bronchoscope combined with non-invasive positive pressure ventilation can effectively optimize the arterial blood gas levels, reduce systemic inflammatory stress state and protect the myocardial function of patients with COPD complicated by severe pneumonia.

Non-Invasive Positive Pressure Ventilation (NIPPV) in the Pregnant Patient: A Case Series

Rationale: Acute respiratory failure is an uncommon complication of pregnancy. However, it is the most frequent organ dysfunction associated with obstetric admissions to an intensive care unit. The obstetric population is a different group due to its physiology and the presence of the fetus that lacks evidence in the literature within the subject of ventilatory support. Noninvasive positive pressure ventilation (NIPPV) is often avoided due to the lack of knowledge on the safety and efficacy of this modality. Currently, there are no guidelines for the management of respiratory failure in pregnancy. Objectives: To provide evidence in support of the use of NIPPV as a safe and reasonable modality for pregnant patients with respiratory failure. Methods: We retrospectively reviewed medical records of 29 pregnant patients of the Obstetric Critical Care Unit of a tertiary hospital in Panamá City who received NIPPV from 2013 to 2015. Failure to response was defined as the lack of increase in the paO2/FiO2 ratio or clinical deterioration 6 hours after initiating NIPPV. Demographics, indication for NIPPV, duration of treatment, as well as maternal and fetal outcomes were collected. Measurements and Main Results: Mean age was 28.4 ± 6 years, mean body mass index 27.4 ± 3.3, and mean gestational age at admission was 305/7 ± 5 weeks. Twenty-four patients (82.8%) met the criteria for acute lung injury (ALI) and an additional two (6.9%) for acute respiratory distress syndrome (ARDS). The mean duration of ventilation was 50.6 ± 17.27 hours. Statistically significant differences were noted between the paO2/FiO2 ratios in failure and successful patients within 2 hours of NIPPV therapy (P = 0.007) and paO2/FiO2 ratio within 6 hours of NIPPV therapy (P = 0.03). Success was defined when the patient was administered NIPPV, resulting in an improvement (increase in pa/FiO2 ratio) of her ventilatory parameters. Three patients (10.3%) failed to respond to NIPPV and needed to be converted to invasive mechanical ventilation. Patients who required intubation had a longer duration of ICU stay (P = 0.006) and overall hospital stay (P = 0.03). None of patients presented aspiration during NIPPV therapy. Conclusion: The current series is the largest report of pregnant patients requiring ventilatory support who received NIPPV as first line of therapy. This report shows the usefulness of this ventilation modality, avoiding intubation with its risks, of a significant number of patients, especially ventilator-associated pneumonia.

The Value of Positive Pressure Ventilations for Clients in Acute Respiratory Distress as a Result of Cardiac and Pulmonary Issues

Objective: Research was conducted to examine benefits to using non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) early in the treatment of respiratory distress caused by pulmonary edema, chronic obstructive pulmonary disease (COPD) and asthma. Limitations to successful NIV and CPAP therapy were evaluated to determine how prolonged initiation of treatment may lead to hypoxemia (decreased oxygen in the blood) and hypercapnia (increased carbon dioxide in the blood) resulting in poor outcomes. Method: Reviews of literature from nursing and allied health data bases (CINAHL and ProQuest) with terms pulmonary edema, positive pressure device and non-invasive ventilation from 2010 to 2014 were used. Studies were conducted in the hospital and prehospital settings. Results: The literature search located 7 articles from CINAHL and 25 articles from ProQuest. A total of 6 of these articles were analyzed. Additional sources of data were obtained from Ignatavicius and Workman (2013) Medical-Surgical Nursing Patient-Centered Collaborative Care 7th edition and American Journal of Nursing (02/2013) Volume 113: 2. Conclusion: All of the articles concluded that early initiation of continuous positive airway pressure ventilations in the short-term was beneficial;however, late initiation of therapy required additional interventions. The studies indicated that early use of positive airway pressure in acute respiratory distress improved breath rate, heart rate and blood pressure. The use of positive airway pressure for respiratory distress may decrease the need for endotracheal intubation.

Long-term non-invasive positive pressure ventilation in severe stable chronic obstructive pulmonary disease： a meta-analysis

Background The evidence for non-invasive positive pressure ventilation （NIPPV） used in patients with severe stable chronic obstructive pulmonary disease （COPD） is insufficient. The aim of the meta-analysis was to assess the treatment effects of long-term NIPPV on gas change, lung function, health-related quality of life （HRQL）, survival and mortality in severe stable COPD patients. Methods Randomized controlled trials （RCTs） and crossover studies comparing the treatment effects of NIPPV with conventional therapy were identified from electronic databases and reference lists from January 1995 to August 2010. Two reviewers independently assessed study quality. Data were combined using Review Manager 5.0. Both pooled effects and 95% confidence intervals were calculated. Results Five RCTs and one randomized crossover study with a total of 383 severe stable COPD patients were included NIPPV improved gas change significantly when using a higher inspiratory positive airway pressures. The weighted mean difference （WMD） for the partial pressure of carbon dioxide in artery （PaCO2） was -3.52 （-5.26, -1.77） mmHg and for the partial pressure of oxygen in artery （PaO2） 2.84 （0.23, 5.44） mmHg. There were significant improvements in dyspnea and sleep quality, but gained no benefits on lung function. The standardized mean difference （SMD） for the forced expiratory volume in 1 second （FEV1） was 0.00 （0.29, 0.29）. And the benefits for exercise tolerance, mood, survival and mortality remained unclear. Conclusions Patients with severe stable COPD can gain some substantial treatment benefits when using NIPPV, especially improvements in gas change, dyspnea and sleep quality. Studies of high methodological quality with large population, especially those based on a higher inspiratory positive airway pressures are required to provide more evidences.

局部正压通风方法解决采面低氧问题的试验及模拟研究

针对浅埋近距离煤层群工作面易产生低氧现象的难题,以山西某矿3105工作面低氧问题为研究背景,采用理论分析、相似模拟及数值模拟方法进行了研究。分析得出煤层地质条件、工作面通风方式、大气压力变化和自然风压是工作面产生低氧现象的主要原因,并探究了采用局部正压通风方法解决采面低氧问题的可行性。结果表明:采用负压通风时,增加风速不能明显提高工作面上隅角区域的氧气体积分数,仍低于20%;采用局部正压通风时,采场内20%氧气体积分数等值线在通风风速达到1.6 m/s时,与工作面呈平行状态,增加风速能有效提高采面上隅角的氧气体积分数;采用局部正压通风回风巷增阻时,相较于单一的局部正压通风能够在更小的风速条件下解决采面低氧的问题,且一定程度上有利于防范采空区遗煤自然发火。利用COMSOL仿真软件,建立工作面采场气体运移模型,开展了不同通风方法、不同风速条件下的采空区氧气体积分数分布及运移规律研究,数值模拟结果与试验测定结果基本一致。3105工作面现场实践表明,采用局部正压通风回风巷增阻的技术措施能够有效解决工作面低氧问题,工作面上隅角及回风流的氧气体积分数由15%上升到20%以上,并始终保持正常水平,确保了工作面的安全生产。

Clinical Study on Respiratory Medicine Treatment of Chronic Obstructive Pulmonary Disease Combined with Respiratory Failure

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.

亚低温下呼气末正压通气对成人急性呼吸窘迫综合征氧代谢情况及预后结局的影响研究

目的:观察亚低温下呼气末正压通气(PEEP)对改善成人急性呼吸窘迫综合征(ARDS)氧代谢情况及预后结局的影响。方法:选取2021年5月—2022年5月在南阳市第一人民医院接受持续正压通气治疗的126例ARDS患者作为研究对象。采用抽签法将患者分为两组,每组各63例。对照组予以常规体温下PEEP治疗。观察组予以亚低温下PEEP治疗。比较两组患者治疗前后的肺部炎症指标、氧代谢指标变化情况以及两组患者的治疗情况、预后结局。结果:治疗后,观察组患者的肺部局部白细胞介素-6(IL-6)、血清降钙素原(PCT)、C-反应蛋白(CRP)水平均低于对照组,差异有统计学意义(t=4.973、6.714、4.442,P<0.05);观察组患者的氧分指数(P/F)、混合静脉血氧饱和度(SvO2)高于对照组、血清乳酸水平(LAC)水平低于对照组,差异有统计学意义(t=2.901、2.974、10.809、P<0.05);观察组的肺顺应性高于对照组,ICU住院时长、机械通气时长均低于对照组,差异有统计学意义(t=9.476、6.907、3.530,P<0.05);观察组患者并发症发生率(7.94%)低于对照组(19.05%)、病死率(4.76%)低于对照组(15.87%),差异有统计学意义(χ^(2)=5.287、6.671,P<0.05)。结论:采用亚低温技术配合PEEP可促进ARDS患者的肺部炎症反应及氧代谢情况恢复,可增加患者临床获益并改善预后结局。

Need for oxygen therapy and ventilatory support in premature infants in a hospital in Southern Brazil

BACKGROUND Prematurity in newborns is a condition that is associated with worse hospital outcomes when compared to birth to term.A preterm infant(PI)is classified when gestational age(GA)<37 wk.AIM To analyze prognostic indicators related to the use of oxygen therapy,noninvasive ventilation(continuous positive airway pressure)and mechanical ventilation(MV)in PI.METHODS This is a retrospective cohort.The sample was composed of PIs from a private hospital in southern Brazil.We included neonates with GA<37 wk of gestation in the period of January 1,2018 to December 31,2018.For data collection,electronic records were used in the Tasy Philips^(TM)system,identifying the variables:maternal age,type of birth,prenatal information,GA,Apgar score,birth weight,neonatal morbidities,vital signs in the 1st hour at birth,need for oxygen therapy,continuous positive airway pressure and MV,hospitalization in the neonatal intensive care unit,length of stay and discharge or death.RESULTS In total,90 PI records were analyzed.The median(p25-p75)of GA was 34.0(31.9-35.4)wk,and there were 45(50%)males.The most common morbidity among PIs was the acute respiratory discomfort syndrome,requiring hospitalization in the neonatal intensive care unit in 76(84.4%)cases.The utilization rate of oxygen therapy,continuous positive airway pressure and MV was 12(13.3%),37(41.1%)and 13(14.4%),respectively.The median(p25-p75)length of stay was 12.0(5.0-22.2)d,with 10(11.1%)deaths.A statistical association was observed with the use of MV and GA<28 wk,lower maternal age,low birth weight,Apgar<8 and neonatal deaths.CONCLUSION The identification of factors related to the need for MV in prematurity may help in the indication of a qualified team and technologies to promptly meet the unforeseen events that may occur after birth.

正压通风对浅埋煤层漏风影响及漏风综合治理技术研究

浅埋近距离煤层群受采动影响大,采煤工作面普遍存在漏风维度多、漏风通道互联导通的现象,在正压或负压通风的作用下,易在漏风通道两端形成较大漏风压差,导致工作面漏风量增加,采空区“三带”范围延长,自然发火危险性增大。以典型正压通风矿井大柳塔煤矿活鸡兔井12煤为研究对象,分析得出正压通风条件下浅埋煤层的漏风影响因素主要表现为:采动裂隙构成的漏风通道、正压通风形成的漏风压差、通风方式及自然风压作用,考察正在回采的12下203综放工作面的漏风现状及漏风方式,总结得出工作面的漏风主要表现为:地表塌陷裂隙漏风、工作面切眼与两巷漏风及采空区漏风。基于此,提出全方位多覆盖立体式漏风治理技术,该技术以优化通风系统为基础,以巷道煤岩裂隙注浆、喷浆技术、保护煤柱漏风控制技术、工作面采空区端头漏风控制技术为保障,以局部正压漏风控制技术、水力冲缝堵漏技术、充填钻孔堵漏技术为强化手段,从基础优化、中间保障到末端治理为理念,全方位多覆盖立体式治理漏风。并在12下203综放工作面实际应用,将12下203综放工作面漏风量由初采期间的55~70 m^(3)/min降低至6~20 m^(3)/min,综合降低幅度达80.3%,证实此技术能有效治理漏风,可为相似矿井的漏风治理提供技术参考。

食管引流型与标准型喉罩通气道用于正压通气的自身对照研究

目的 采用随机自身对照设计方法比较食管引流型喉罩通气道（PLMA）和标准型喉罩通气道（SLMA）用于间歇正压通气的有效性。方法 选择50例经美国麻醉医师协会（ASA）身体状态分级标准分为1～2级、拟在全身麻醉下实施择期整形外科手术患者。在常规麻醉诱导后，顺序插入PLMA和SLMA，将通气罩内压充气至60cmH2O（1cmH2O=0．098kPa），评价两种喉罩通气道充气前后的肺通气满意度和气道密封压，同时进行光导纤维支气管镜（FOB）评分，确定通气罩的解剖位置。然后将潮气量设定为10ml／kg实施间歇正压通气，记录间歇正压通气后连续5次呼吸的平均呼潮气量和平均吸气峰压。结果 在通气罩未充气情况下，插入PLMA后有46例（92％）患者获得了良好和尚可的肺通气效果，而插入SLMA后仅有22例（44％）患者获得了良好和尚可的肺通气效果；PLMA的气道密封压显著高于SLMA（P〈0．05）。将通气罩内压充气至60cmH2O，采用PLMA的50例患者均获得良好的肺通气效果，但采用SLMA时仅有28例获得良好的肺通气效果；PLMA所需的充气量和充气后获得的气道密封压均显著高于SLMA（P均〈0．05）。采用PLMA时所有患者的气道密封压均高于或等于采用SLMA时；采用PLMA时除2例患者外，其他患者所需的充气量也均高于采用SLMA时。PLMA通气罩位置的FOB评分显著低于SLMA（P〈0．05）。采用PLMA维持气道的29例患者和采用SLMA维持气道的21例患者的平均呼潮气量、吸气峰压及维持气道时间差异均无显著性（P均〉0．05）。结论 与SLMA相比，PLMA可为正压通气提供更好的气道密封压，而且对声门和食管上端具有潜在的隔离作用，用于正压通气时PLMA比SLMA更有效、更安全。

序贯性机械通气技术及其临床应用

对有创正压通气技术与无创正压通气技术进行比较。介绍了有创——无创序贯性机械通气这一新的通气技术, 文章结合临床实际对这项新技术进行了分析。

有创与无创序贯性机械通气技术

有创正压机械通气技术在临床应用已有近百年历史。无创正压机械通气技术应用于临床也有10余年。有创与无创序贯性机械通气是一项新的通气技术 。

不同通气模式对腹腔镜下Trendelenburg体位患者肺通气的影响

目的采用电阻抗断层成像(EIT)技术观察容量控制通气(VCV)和压力控制容量保证通气(PCV-VG)模式对腹腔镜下Trendelenburg体位患者全麻术中肺通气的影响。方法择期全麻下行腹腔镜下Trendelenburg体位妇科手术患者60例,年龄40~65岁,BMI 18~30 kg/m 2,ASAⅠ或Ⅱ级,采用随机数字表法将患者分为两组:VCV模式组(V组)和PCV-VG模式组(P组),每组30例。V组术中采用VCV模式,P组采用PCV-VG模式。记录入室后(T 0)、插管后5 min(T 1)、更改体位(由平卧位更改为Trendelenburg体位)后即刻(T 2)、更改体位后30 min(T 3)、更改体位后60 min(T 4)、更改体位后120 min(T 5)、改平卧位(T 6)时的MAP、HR、通气中心(CoV)、依赖静止区(DSS)、非依赖静止区(NSS)的面积百分比。记录T 1、T 3—T 5时气道峰压(Ppeak)、pH、PaO 2、PaCO 2、氧合指数(OI)。记录术后7 d内肺部感染、呼吸衰竭等肺部并发症发生情况。结果T 0—T 6时两组MAP、HR差异无统计学意义。与V组比较,T 3—T 6时CoV面积百分比明显升高,DSS面积百分比明显降低(P<0.05),T 3—T 5时Ppeak明显降低(P<0.05),T 4、T 5时PaO 2、OI明显升高(P<0.05)。两组术后7 d内均无肺部并发症。结论PCV-VG通气模式可明显改善腹腔镜下Trendelenburg体位患者术中肺通气及肺氧合功能。

经鼻高流量湿化氧疗对呼吸衰竭患者治疗的研究进展

氧疗是急性呼吸衰竭的一线治疗策略,其中非侵入性氧疗包括无创正压通气(NPPV)、标准氧(鼻导管吸氧)和经鼻高流量(HFNC)湿化氧疗。HFNC是新型辅助呼吸方式,近几年在临床上得到快速普及并推广。虽然HFNC是一种新型的呼吸支持技术,但其在临床的规范使用和适用范围尚需进一步临床研究。为了能更好地挽救患者生命,并积极促进患者早日康复,本文通过查阅相关文献,对比HFNC、标准氧和NPPV的治疗效果,以明确HFNC的治疗优势。

无创正压通气规范化培训在心脏外科护士培训中的应用效果

目的探讨无创正压通气(noninvasive positive pressure ventilation,NPPV)规范化培训在心脏外科护士培训中的应用效果。方法便利抽样选取2015年6月至2016年12月入职我院心脏外科的护士30名,采用NPPV规范化培训的方式,对其进行培训和考核,并对结果进行分析。结果通过规范化培训与考核,心脏外科护士应用NPPV理论与技能考试不合格率由80%降至4.2%(P<0.05),处理常规报警时间平均缩短5 min(P<0.05),同时医生对护士满意率由72%提高到96%。结论无创通气规范化培训有效提高了护士的无创通气临床知识及操作技能,值得临床推广应用。

Efficacy of high-flow nasal cannula on acute exacerbation of chronic obstructive pulmonary disease: A meta-analysis

Objective:To systematically evaluate the efficacy and feasibility of high-flow nasal cannula(HFNC)on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:Systematic searches on PubMed,Web of Science,the Cochrane Library,Embase,CBM(Chinese Biomedicine Database),CNKI(China National Knowledge Infrastructure),Wanfang Database and VIP were performed for randomized controlled trials(RCTs)which explored the effects of HFNC on patients with AECOPD.The retrieval time was from the establishment of each database to July 2019.RevMan5.3 software was used for statistical analysis.Results:A total of 12 articles were included,involving 812 patients.The results showed that:(1)Compared with conventional oxygen therapy,HFNC could improve patients'arterial partial oxygen pressure(PaO2)(MD=12.70,95%CI(7.00,18.40),Z=4.37,P<0.0001),reduce partial arterial blood carbon dioxide(PaCO2)(MD=-10.99,95%CI(-14.42,-7.55),Z=6.26,P<0.00001)and reduce endotracheal intubation rate(OR=0.19,95%CI(0.04,0.93),Z=2.05,P=0.04),shorten the hospitalization time(SMD=-0.74,95%CI(-1.11,-0.37),Z=3.95,P<0.0001).(2)Compared with non-invasive positive pressure ventilation,it has fewer adverse reactions(OR=0.18,95%CI(0.09,0.35),Z=5.08,P<0.00001)and shorter hospital stay(SMD=-0.57,95%CI(-0.90,-0.23),Z=3.33,P=0.0009).Conclusion:HFNC can improve the patients’hypoxia symptoms and CO2 retention,reduce the rate of tracheal intubation,and alleviate adverse reactions.However,Limited by the quality and region of the included studies,more high-quality are needed to test it.

浅埋综放工作面初采期间CO异常涌出机理及治理技术

浅埋综放工作面CO异常涌出现象频繁发生,以6104工作面为背景,采用理论分析、现场实测等方法,分析了工作面初采期间CO来源,建立了CO异常涌出结构模型,揭示了CO异常涌出机理,提出了地面、井下协同治理CO超限技术。结果表明:6#煤风氧化带和4#、5#煤中赋存的CO是工作面CO的来源;采空区覆岩贯通性裂缝提供了导气通道;负压通风是气体向工作面反向流动的力源。正压通风、采空区注氮、提高回采率、地面填埋等技术,有效控制了CO的超限问题,现场监测结果证明了该技术的可靠性。

标准化无创正压通气技术在慢阻肺呼吸衰竭护理中对病人血气分析指标的影响研究

目的:分析慢阻肺呼吸衰竭患者采取无创正压通气的调节效果。方法:将蚌埠医学院第二附属医院接受治疗的75例呼吸衰竭患者作为研究对象,均为2021年5月-2022年5月期间收治,分为常规组与观察组,常规组患者接受常规治疗,观察组患者在常规组基础上加用标准化无创正压通气技术,比较两组患者治疗有效率、R、动脉血气指标、生活自理能力。结果:观察组患者疗效高于常规组患者,P<0.05;观察组患者R与SaO_(2)高于常规组,PaO_(2)与PaCO_(2)低于常规组,P<0.05;观察组患者生活自理能力高于常规组患者,P<0.05。结论:无创正压通气技术能够调节患者血气分析指标,其效果显著,可以考虑积极推广。