TY - T1的无创性通气支持不促进复苏在慢性阻塞性肺疾病急性呼吸衰竭JF -欧洲呼吸杂志》乔欧元和J SP - 1240 LP - 1245 - 10.1183 / 09031936.96.09061240六世- 9 - 6盟Barbe F AU - Togores, B非盟- Rubi M AU -脑桥,年代盟——Maimo盟——Agusti AG Y1 - 1996/06/01 UR - //www.qdcxjkg.com/content/9/6/1240.abstract N2 -这个调查评估,在未来,通过随机和对照的方法，研究了无创通气支持(NIVS)与双水平气道正压(BiPAP)是否有助于慢性阻塞性肺疾病(COPD)患者急性呼吸衰竭(ARF)的恢复。24例COPD患者(平均年龄(+/- sem) 68 +/- 2岁)(预测出院时一秒钟用力呼气量(FEV1) 33 +/- 2%)，因急性肾功能衰竭(pH值7.33 +/- 0.01;动脉氧张力(Pa,O2) 6.0 +/- 0.2 kPa;动脉二氧化碳张力(Pa,CO2) 7.9 +/- 0.3 kPa)，初始随机化。分配到接受NIVS的14例患者中有4例(29%)不耐受。其余20例患者中，10例在住院的前3天在常规医院病房接受NIVS和BiPAP治疗(两次白天期，每次3小时)。所有20名受试者都接受了氧气、支气管扩张剂和类固醇治疗。在住院第1天和第3天，脱氧治疗和/或BiPAP通气支持前和30分钟后，我们测量了呼气峰值流量、动脉血气值、通气方式、闭塞压(P0.1)、最大吸气压(MIP)和最大呼气压(MEP)。所有患者均出院，无需气管插管和机械通气。 Hospitalization time was similar in both groups (11.3 +/- 1.3 vs 10.6 +/- 0.9 days, control vs BiPAP, respectively). Arterial oxygenation, respiratory acidosis and airflow obstruction improved significantly throughout hospitalization in both groups. By contrast, the ventilatory pattern, P0.1, MIP and MEP did not change. NIVS with BiPAP did not cause any significant difference between groups. We conclude that noninvasive ventilatory support with bilevel positive airway pressure does not facilitate recovery from acute respiratory failure in patients with chronic obstructive pulmonary disease. Furthermore, a substantial proportion of patients (29%) do not tolerate noninvasive ventilatory support under these circumstances. From these results, we cannot recommend the use of noninvasive ventilatory support with bilevel positive airway pressure in the routine management of chronic obstructive pulmonary disease patients recovering from acute respiratory failure. ER -