Jurjević Matija, Matić Ivo, Sakić-Zdravcević Katarina, Sakić Simun, Danić Davorin, Buković Damir
Department of Anaesthesiology and Intensive Care, General Hospital "Dr. Josip Bencević", Slavonski Brod, Croatia.
Coll Antropol. 2009 Sep;33(3):791-7.
Acute respiratory failure due to chronic obstructive pulmonary disease (COPD) presents an increasing problem throughout the world. The aim of this study was to compare invasive and non-invasive mechanical ventilation (MV) for patients with COPD. A prospective, randomized trial was performed in a multidisciplinary intensive care unit for the period of 36 months and included 156 patients with COPD. MV procedure was performed using standard methods, and was applied as either invasive MV (IMV) or noninvasive MV (NIMV). Patients were randomized in two groups for application of MV using closed, nontransparent envelops. Comparison was made based on patient characteristics, objective parameters on admission and 1h, 4h, 24h, and 48h after admission and based on treatment outcome. We have confirmed that NIMV method is superior to IMV for patients with COPD. MV duration NIM:IMV was 94:172 hours, p < 0.001, time spent in Intensive Care Unit 120:223 hours, p < 0.001. Ventilator associated pneumonia 5(6%):29(37%), p < 0.001. The advantage of NIMV in COPD patients, especially in the early stages was confirmed.
慢性阻塞性肺疾病（COPD）所致急性呼吸衰竭在全球范围内是一个日益严重的问题。本研究旨在比较COPD患者的有创和无创机械通气（MV）。在一个多学科重症监护病房进行了一项为期36个月的前瞻性随机试验，纳入了156例COPD患者。MV采用标准方法进行，分为有创MV（IMV）或无创MV（NIMV）。使用不透明密封信封将患者随机分为两组进行MV治疗。根据患者特征、入院时及入院后1小时、4小时、24小时和48小时的客观参数以及治疗结果进行比较。我们证实，对于COPD患者，NIMV方法优于IMV。NIMV与IMV的MV持续时间分别为94小时和172小时，p<0.001；在重症监护病房的时间分别为120小时和223小时，p<0.001。呼吸机相关性肺炎的发生率分别为5例（6%）和29例（37%），p<0.001。NIMV在COPD患者尤其是早期患者中的优势得到了证实。
