Effects of parameters of BiPAP ventilator on compliances of chest and lung,and arterial blood gas indexes of AECOPD patients

Xiaoxia LIU; Juan SUN; Yasheng MILAWA

ABSTRACT

Objective:

To explore the effects of ventilator parameters on the compliances of chest and lung,and arterial blood gas indicators of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)when biphasic positive airway pressure(BiPAP)ventilation treated AECOPD patients at acute exacerbation period.

Method:

A total of 78 AECOPD patients who underwent non-invasive ventilation treatment by using BiPAP ventilators in Xinjiang Cardiovascular and Cerebrovascular Hospital from April 2020 to April 2021 were selected.The common range of inspiratory positive airway pressure(IPAP)was 10-25 cmH2O.Based on the specific situation and adjustment of clinical needs of patients,this study set"<15 cmH2O"as the low IPAP group(n=34),and set"≥15 cmH2O"as the high IPAP group(n=44)to analyze the correlation between IPAP of BiPAP ventilator parameters and the therapeutic effects,chest lung compliances and arterial blood gas indicators of patients.

Results:

The rate of therapeutic effect of patients in the high IPAP group was 93.48%,which was significantly higher than 71.88%of the low IPAP group,and the difference between the two groups was statistically significant(x2=6.766,P<0.05).Before treatment,there were no statistically significant differences in indicators included chest compliance(CTh),lung compliance(CL)and total compliance(Ct)between the two groups(P>0.05).After treatment,the Ct,CL and CTh of patients in the high IPAP group were significantly higher than those in the low IPAP group,and the differences between the two groups were statistically significant(t=2.508,2.027,2.185,P<0.05),respectively.There was no statistically significant difference in arterial oxygen partial pressure(PaO2)value between the two groups before used mechanical ventilation(P>0.05).The PaO2 values of patients at 2,4,6 and 8h of using mechanical ventilation in the high IPAP group were significantly higher than those in the low IPAP group,and the differences between different groups were statistically significant(t=8.531,5.296,3.264,4.623,P<0.05),respectively.Both two groups of patients showed a significant increase in inflammatory mediators such as matrix metalloproteinase-9(MMP-9)and interleukin-8(IL-8)during occurring disease.After treatment,the levels of the two mediators decreased,and the high IPAP group was significantly lower than that of low IPAP group(t=2.251,5.484,P<0.05),respectively.The incidence of abdominal distension in patients of high IPAP group was 20.45%,which was significantly higher than 5.88%of low IPAP group,and the difference between groups was statistically significant(x2=3.623,P<0.05).

Conclusion:

The IPAP of BiPAP ventilator parameters has effect on chest lung compliance,arterial blood gas analysis and inflammatory indicators in AECOPD patients.High IPAP can improve therapeutic effect,and improve chest lung compliance and arterial blood gas analysis,but can easily cause adverse reactions such as abdominal distension.