慢性阻塞性肺疾病所致急性呼吸衰竭的无创机械通气：成功的相关因素
Non-invasive mechanical ventilation in acute respiratory failure due to chronic obstructive pulmonary disease: correlates for success.
作者信息
Ambrosino N, Foglio K, Rubini F, Clini E, Nava S, Vitacca M
机构信息
Department of Pulmonary Rehabilitation, Centro Medico di Montescano, Italy.
出版信息
Thorax. 1995 Jul;50(7):755-7. doi: 10.1136/thx.50.7.755.
BACKGROUND
Non-invasive mechanical ventilation is increasingly used in the treatment of acute respiratory failure in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to identify simple parameters to predict the success of this technique.
METHODS
Fifty nine episodes of acute respiratory failure in 47 patients with COPD treated with non-invasive mechanical ventilation were analysed, considering each one as successful (78%) or unsuccessful (22%) according to survival and to the need for endotracheal intubation.
RESULTS
Pneumonia was the cause of acute respiratory failure in 38% of the unsuccessful episodes but only in 9% of the successful ones. Success with non-invasive mechanical ventilation was associated with less severely abnormal baseline clinical and functional parameters, and with less severe levels of acidosis assessed during an initial trial of non-invasive mechanical ventilation.
CONCLUSIONS
The severity of the episode of acute respiratory failure as assessed by clinical and functional compromise, and the level of acidosis and hypercapnia during an initial trial of non-invasive mechanical ventilation, have an influence on the likelihood for success with non-invasive mechanical ventilation and may prove to be useful in deciding whether to continue with this treatment.
背景
无创机械通气在慢性阻塞性肺疾病（COPD）患者急性呼吸衰竭的治疗中应用越来越广泛。本研究旨在确定预测该技术成功的简单参数。
方法
分析了47例接受无创机械通气治疗的COPD患者的59次急性呼吸衰竭发作，根据生存情况和气管插管需求将每次发作视为成功（78%）或失败（22%）。
结果
在38%的失败发作中，肺炎是急性呼吸衰竭的原因，但在成功发作中仅占9%。无创机械通气成功与基线临床和功能参数异常程度较轻，以及在无创机械通气初始试验期间评估的酸中毒程度较轻有关。
结论
通过临床和功能损害评估的急性呼吸衰竭发作的严重程度，以及无创机械通气初始试验期间的酸中毒和高碳酸血症水平，对无创机械通气成功的可能性有影响，可能有助于决定是否继续这种治疗。
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