Application of Noninvasive Positive Pressure Ventilation in Patients with Acute Left Heart Failure_West China Medical Journal

Authors：

 LiuXiaoyi , ZhengXiangde , LiuHui

Department of Critical Care Medicine, the Central Hospital of Dazhou, Dazhou, Sichuan 635000, P. R. China;

Corresponding author：

Keywords：

Noninvasive positive pressure ventilation; Acute left heart failure; Mechanical ventilation; Cardiogenic pulmonary edema

DOI：

10.7507/1002-0179.201600179

Video：

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Objective To investigate the effects of noninvasive positive pressure ventilation (NPPV) on patients with acute left heart failure. Methods Twenty patients with acute left heart failure diagnosed between September 2013 and July 2014 were randomized into treatment group (n=10) and control group (n=10). Both groups used conventional sedations, diuretics and drugs that strengthened the heart and dilated the vessels, while early use of NPPV was applied in the experimental group. Arterial blood gas analysis [pH value, pressure of arterial carbon dioxide (PaCO₂), and pressure of arterial oxygen (PaO₂)], heart rate (HR), respiration, duration of Intensive Care Unit (ICU) stay and invasive mechanical ventilation, duration of overall mechanical ventilation, and success case numbers before and two hours after treatment were observed and analyzed. Results For the control group, two hours after treatment, PaO₂ was (67.0±8.5) mm Hg (1 mm Hg=0.133 kPa), HR was (124±10) times/min, Respiration was (34±4) times/min, the duration of ICU stay was (6.0±1.1) days, invasive ventilation was for (32.0±3.1) hours, and the total time of mechanical ventilation was (32.0±3.1) hours. Those indexes for the treatment group two hours after treatment were: PaO₂, (82.3±8.9) mm Hg; HR, (98±11) times/min; respiration, (24±4) times/min; the duration of ICU stay, (4.0±0.8) days; invasive ventilation time, (16.0±1.3) hours; the total time of mechanical ventilation, (26.0±1.8) hours. All the differences for each index between the two groups were statistically significant (P < 0.05). Conclusion Early application of NPPV can rapidly relieve clinical symptoms and reduce the medical cost for patients with acute left heart failure.

Citation： LiuXiaoyi, ZhengXiangde, LiuHui. Application of Noninvasive Positive Pressure Ventilation in Patients with Acute Left Heart Failure. West China Medical Journal, 2016, 31(4): 650-652. doi: 10.7507/1002-0179.201600179 Copy

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1. 中华医学会心血管病学分会. 急性心力衰竭诊断和治疗指南[J].中华心血管病杂志, 2010, 38(3): 195-208.
2. 崔锦女. 急性心源性肺水肿患者的护理体会[J].中国保健营养: 中旬刊, 2014, 24(5): 3069.
3. 胡秀容. 急性左心衰136临床分析[J]. 中国卫生产业, 2013, (27): 15-17.
4. 尹代双. 60例急性左心衰的发病诱因及临床治疗观察[J]. 心血管病防治知识, 2013, (6): 38-39.
5. 周运东. 老年急性左心衰的临床特点及治疗对策探讨[J]. 齐齐哈尔医学院学报, 2014, 35(9): 1318-1319.
6. 李雪梅. 急性左心衰患者救治的临床疗效观察[J]. 贵阳中医学院学报, 2013, 35(3): 96-98.
7. 彭海军. 乌拉地尔联合硝酸甘油治疗急性左心衰伴高血压的疗效观察[J]. 现代诊断与治疗, 2013, 24(8): 1879-1880.
8. 王辉华. 硝普钠治疗急性左心衰竭的临床效果分析[J]. 中国医药科学, 2013, 3(2): 73-74.
9. 吴华容. 磷酸肌酸钠治疗急性左心衰的疗效观察[J]. 齐齐哈尔医学院学报, 2013, 34(10): 1450-1451.
10. 王胜文, 李莉红, 王慧慧. 呼吸机治疗急性左心衰36例临床分析[J]. 中国实用医药, 2013, 8(5): 126-127.
11. 周朝霞. 急性左心衰的健康指导[J]. 中国社区医师: 医学专业, 2012, 14(6): 381-381.
12. 牛春燕. 强心利尿扩血管药物治疗心力衰竭的体会[J]. 医学信息, 2011, 24(9): 5818-5819.
13. 刘小毅, 郑祥德, 吴昌徽. 严重心功能不全致呼吸机依赖患者成功脱机一例[J]. 华西医学, 2013, 28(12): 1964.
14. 陈亚利, 霍敏琴, 杨梅. 无创正压通气在治疗急性左心衰中的应用价值研究[J]. 中国实用内科杂志, 2005, 25(5): 428-430.
15. 冯玉玺. 无创持续正压通气治疗急性心源性肺水肿[J]. 医学综述, 2008, 14(14): 2141-2143.
16. 冯春微, 许少辉, 廖静, 等. 无创呼吸机通气治疗急性左心衰23例的临床分析[J]. 现代预防医学, 2011, 38(16): 3357-3359.
17. 陈锋, 刘景峰, 张万义. 无创机械通气对重度急性左心衰疗效观察[J]. 河北医学, 2014, 36(16): 2437-2439.

West China Medical Journal

Application of Noninvasive Positive Pressure Ventilation in Patients with Acute Left Heart Failure

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