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.