Noninvasive ventilation with complex critical care ventilator in the treatment of acute exacerbation of chronic obstructive pulmonary disease

Abstract

Objective: To compare the clinical effect of noninvasive positive-pressure ventilation (NIPPV), delivered via critical care ventilator or miniventilator, in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: Prospective comparison study. Patients with AECOPD underwent NIPPV via: miniventilator with BiLevel positive airway pressure (BiPAP; Group A); critical care ventilator with pressure support ventilation and positive end expiratory pressure (PSV+PEEP; Group B); critical care ventilator with pressure-synchronized intermittent mandatory ventilation (P-SIMV)+PSV+PEEP (Group C). Physiological parameters were recorded before, during and after ventilation. Results: Patients in Group C (n=21) showed significantly better improvements in physiological parameters (compared with pretreatment values) than those in Group B (n=20) or Group A (n=22). Conclusion: NIPPV delivered via critical care ventilator has a better treatment effect than miniventilator NIPPV in patients with AECOPD. The use of P-SIMV+PSV+PEEP mode provides a significantly better treatment effect than PSV+PEEP alone.