ABSTRACT
Objective:To investigate of optimal flow oxygen-driven aerosol inhalation of budesonide in patients with acute exacerbation of chronic obstructive pulmonary disease, to provides a reference for improving the atomization effect.Methods:Totally, ninety-six patients with acute exacerbation of chronic obstructive pulmonary disease in Guangzhou Red Cross Hospital from June 2019 to December 2020 were collected and assigned to the low flow group, middle flow group and high flow group according to the random number table method, with 32 cases in each group. All patients received oxygen-driven aerosol inhalation of budesonide therapy, the oxygen flow were 4 L/min, 6 L/min and 8 L/min in the three groups, respectively. Before and after 7 days of treatment, the indices including respiratory dynamics, pulmonary function and blood gas analysis were compared among the three groups.Results:There was no significant difference in the indices including respiratory dynamics, pulmonary function and blood gas analysis before treatment among the three groups( P>0.05). After 7 days of treatment, the peak airway pressure, plateau airway pressure, inspiratory resistance were (22.53 ± 3.83) cmH 2O(1 cmH 2O=0.098 kPa), (15.97 ± 3.01) cmH 2O, (23.25 ± 2.92) cmH 2O·L -1·s -1 in the middle flow group, lower than those in the low flow group (26.09 ± 3.04) cmH 2O, (18.13 ± 2.54) cmH 2O, (26.31 ± 3.65) cmH 2O·L -1·s -1 and high flow group (26.13 ± 3.28) cmH 2O, (17.44 ± 2.02) cmH 2O, (25.06 ± 3.56) cmH 2O·L -1·s -1, the pulmonary dynamic compliance was (33.16 ± 4.43) ml/cmH 2O in the middle flow group, higher than that in the low flow group and high flow group (29.84 ± 3.73), (30.47 ± 3.53) ml/cmH 2O, the differences were statistically significant ( F values were 5.96-11.82, all P<0.05). The FEV 1, FEV 1/FVC, ratio of FEV 1 to estimated vital capacity were (1.36 ± 0.26) L, (49.91 ± 5.94)%, (44.81 ± 5.53)% in the middle flow group, higher than those in the low flow group and high flow group (1.23 ± 0.19) L, (45.22 ± 6.56)%, (40.88 ± 5.97)% and (1.20 ± 0.18) L, (46.41 ± 5.30)%, (41.78 ± 6.32)%, the differences were statistically significant ( F=4.91, 5.36, 3.84, all P<0.05). The PaO 2, oxygenation index were (73.06 ± 7.24), (176.18 ± 17.62) mmHg(1 mmHg=0.133 kPa) in the middle flow group, higher than those in the low flow group and high flow group (67.16 ± 5.10), (164.54 ± 12.34) mmHg and (69.44 ± 7.10), (167.07 ± 16.24) mmHg, PaCO 2 was (52.75 ± 6.22) mmHg in the middle flow group, lower than that in the low flow group and high flow group(57.97 ± 6.75), (56.31 ± 6.45) mmHg, the differences were statistically significant ( F=6.61, 4.96, 5.42, all P<0.05). Conclusions:Oxygen-driven aerosol inhalation of budesonide for acute exacerbation of chronic obstructive pulmonary disease patients, oxygen flow are 6 L/min can effectively improve the indices of respiratory dynamics and blood gas analysis as well as improve pulmonary function.