Luo Qun, Li Ying, Chen Rong-Chang, Li Yi-Min
Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510120, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2007 Aug;27(8):1257-9.
To investigate the effect of non-invasive positive pressure ventilation (NIPPV) on the work of breathing (WOB) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).
Eleven patients with acute exacerbation of COPD received pressure support ventilation (PSV) at different levels during NIPPV. The changes of inspiratory muscle effort and breathing pattern of the patients were observed.
The average minute ventilation (VE, P<0.01) and tidal volume (VT, P<0.05) of the patients were significantly higher during routine PSV and high pressure support (H-PS) than those during spontaneous breathing (SB), and the breathing pattern of the patients did not undergo significant changes during high positive end expiratory pressure (H-PEEP). The WOB of the inspiratory muscles was reduced significantly during PSV as compared with that measured in SB (P<0.01), while the WOB of exspiratory muscle increased significantly (P<0.01).
NIPPV can relieve the load of the inspiratory muscles in patients with acute exacerbation of COPD, and the WOB of the inspiratory muscles can be reduced by PSV, H-PEEP and H-PS (by 75%, 71% and 76%, respectively), but higher PSV during NIPPV can cause higher WOB of the exspiratory muscles.
探讨无创正压通气（NIPPV）对慢性阻塞性肺疾病（COPD）急性加重期患者呼吸功（WOB）的影响。
11例COPD急性加重期患者在NIPPV过程中接受不同水平的压力支持通气（PSV）。观察患者吸气肌用力和呼吸模式的变化。
与自主呼吸（SB）相比，患者在常规PSV和高压支持（H-PS）时的平均分钟通气量（VE，P<0.01）和潮气量（VT，P<0.05）显著更高，在高呼气末正压（H-PEEP）时患者的呼吸模式未发生显著变化。与SB时相比，PSV时吸气肌的WOB显著降低（P<0.01），而呼气肌的WOB显著增加（P<0.01）。
NIPPV可减轻COPD急性加重期患者吸气肌的负荷，PSV、H-PEEP和H-PS可降低吸气肌的WOB（分别降低75%、71%和76%），但NIPPV期间较高的PSV可导致呼气肌的WOB升高。
