Effectiveness of remote monitoring and adjusting non-invasive ventilator to improve the symptoms of COPD patients with type Ⅱ respiratory failure

doi:10.3877/cma.j.issn.1674-6902.2020.05.007

Abstract

Abstract:

Objective

To evaluate the effect of remote monitoring and adjusting non-invasive ventilator to improve the symptoms of chronic obstructive pulmonary disease(COPD)patients with type Ⅱ respiratory failure.

Method

All of 70 cases COPD patient with type Ⅱ respiratory failure recruit for this trial and final 60 subjects enrolled in this study. These subjects randomly allocated (1︰1) in the observation group and control group by the random number method. The subjects in the observation group received remote monitoring and adjusting non-invasive ventilator, and the control group received continuous low flow oxygen inhalation. Furthermore, all subjects received COPD therapy. The two groups of subjects were followed up for 1 year and vital signs, arterial blood gas analysis, serum inflammatory factors, quality of life score, and the number of acute exacerbations had been evaluated.

Results

The CAT score, mMRC score, 6 MWD improved after subjects received remote monitoring and adjusting non-invasive ventilator therapy, compared to the control group (P<0.05). Moreover, the level of SaO₂, PaO₂, PCT, IL-6, IL-8 and TNF-α decreased in the observation group, compared to the control group (P<0.05).

Conclusion

Remote monitoring and adjusting non-invasive ventilator effectively improved the symptoms of COPD patients with type Ⅱ respiratory failure, promoted pulmonary rehabilitation of COPD patients.

Key words: Chronic obstructive pulmonary disease, Remote monitoring and adjusting non-invasive ventilator, Clinical efficacy

Chunyan Li, Binfeng He, Dan Wang, Zhixin Gan, Chaowang Huang, Yuding Jiao, Mingdong Hu, Jiancheng Xu. Effectiveness of remote monitoring and adjusting non-invasive ventilator to improve the symptoms of COPD patients with type Ⅱ respiratory failure[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2020, 13(05): 612-617.

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Figures/Tables 6

References 25

1	任成山，王关嵩，钱桂生. 慢性阻塞性肺疾病的成因及其治疗的困惑与希望[J/CD]. 中华肺部疾病杂志(电子版), 2019, 12(2): 127-141.
2	Klaus FR, Henrik W. Chronic obstructive pulmonary disease[J]. Lancet, 2017, 389(10082): 1931-1940.
3	Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010[J]. Lancet, 2012, 380(9859): 2095-20128.
4	Foreman KJ, Marquez N, Dolgert A, et al. Forecasting life expectancy，years of life lost, and all-cause and cause specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories[J]. Lancet, 2018, 392 (10159): 2052-2090.
5	Inmaculada A, Pilar de L, Julio A, et al. 10 Years after EPISCAN: A New Study on the Prevalence of COPD in Spain-a Summary of the EPISCAN Ⅱ Protocol[J]. Arch Bronconeumol, 2019, 55(1): 38-47.
6	Miravitlles M, Soler-cataluna JJ, Calle M, et al. Spanish Guidelines for Management of Chronic Obstructive Pulmonary Disease GESEPOC 2017.Pharmacological Treatment of Stable Phase[J]. Arch Bronconeumol, 2017, 53 (6): 324-335.
7	Pleguezuelos E, Gimeno SE, Hernandez C, et al. Recommendations on non-pharmacological Treatment in Chronic Obstructive Pulmonary Disease From the Spanish COPD Guidelines (GESEPOC 2017)[J]. Arch Bronconeumol, 2018, 54 (11): 568-575.
8	Sietske van der L, Marieke LD. High-intensity non-invasive ventilation in stable hypercapnic COPD: evidence of efficacy and practical advice[J]. Respirology, 2019, 24(4): 318-328.
9	Ram FSM, Picot J, Lightowler J, et al. Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease[J]. Cochrane Database Syst Rev, 2004, (1): CD004104.
10	Vasiliki T, Chaido P, Eleni K, et al. One-year non-invasive ventilation in chronic hypercapnic COPD: Effect on quality of life[J]. Respir Med, 2008, 102(6): 904-911.
11	元　梅，韩其政，赵　慧，等. 家庭无创正压通气对COPD合并呼吸衰竭病人生活质量的影响[J]. 中国老年学杂志，2012, 32(20): 4561-4563.
12	Holland AE, Spruit MA, Troosters T, et al. An Offificial European Respiratory Society/American Thoracic Society Technical Standard: fifield walking tests in chronic respiratory disease[J]. Eur Respir J, 2014, 44(6): 1428-1246.
13	Hernandes NA, Wouters EF, Meijer K, et al. Reproducibility of 6-minute walking test in patients with COPD[J]. Eur Respir J, 2011, 38(2): 261-267.
14	孙　雅，张彩莲. 长期家庭无创通气对慢性阻塞性肺疾病应用进展的探析[J]. 世界最新医学信息文摘，2018, 18(68): 75-76, 84.
15	Barnes PJ. Mediators of chronic obstructive pulmonary disease[J]. Pharm Rev, 2004, 56(4): 515-548.
16	Shahriary A, Ghanei M, Rahmani H. The systemic nature of mustard lung: comparison with COPD patients[J]. Interdiscip Toxicol, 2017, 10(3): 114-127.
17	Castellucci M, Rossato M, Calzetti F, et al. IL-10 disrupts the Brd4- docking sites to inhibit LPS-induced CXCL8 and TNF-α expression in monocytes: implications for chronic obstructive pulmonary disease[J]. J Allergy Clin Immunol, 2015, 136(3): 781-791.
18	Al-shair Khaled, Umme K, Rachel D, et al. Biomarkers of systemic inflammation and depression and fatigue in moderate clinically stable COPD[J]. Respir Res, 2011, 12(1): 3.
19	朱幼鸣，胡　辉，曾　烨. 无创正压通气辅助治疗对COPD合并Ⅱ型呼吸衰竭患者血气参数、心功能及炎症状态的影响[J]. 海南医学院学报，2017, 23(3): 327-330.
20	王新杰. 孟鲁司特钠联合BiPAP呼吸机对COPD合并呼吸衰竭患者CRP、TNF-α、NT-proBNP的影响[J]. 标记免疫分析与临床，2016, 23(9): 1024-1026.
21	袁一帆，莫伟良，袁楚樊. 无创正压通气治疗对COPD合并Ⅱ型呼吸衰竭患者血气参数及炎症状态的影响[J]. 白求恩医学杂志，2019, 17(2): 147-149.
22	杨东霞，苏炜欣，黄晓霞. 无创正压通气+常规治疗在COPD并Ⅱ型呼吸衰竭患者中的应用价值[J]. 中国医学创新，2019, 16(16): 68-71.
23	周松林，徐文波. 无创机械通气治疗慢性肺源性心脏病合并Ⅱ型呼吸衰竭的临床疗效[J]. 中国现代医学杂志，2015, 25(12): 106-109.
24	王春芳，于耀龙，赵富栋. 孟鲁司特钠联合双水平气道正压通气呼吸机治疗哮喘-慢性阻塞性肺疾病重叠综合征的效果[J]. 中国临床实用医学，2018, 9(4): 25-29.
25	赵树凯. 孟鲁司特钠对COPD急性加重期患者肺功能和诱导痰TNF-α、IL-8的影响[J]. 北方药学，2019, 16(5): 76-77.

临床资料		观察组(n＝30)	对照组(n＝30)	P值
年龄(岁)		67.47±9.56	67.8±8.92	0.83
性别[男(%)]		63.33(19)	60.00%(18)	0.79
	[女(%)]	36.67(11)	40.00(12)	0.80
RR(次/min)		21.47±1.41	21.3±1.84	0.70
HR(次/min)		84.87±5.27	83.53±5.44	0.34
pH		7.37±0.04	7.38±0.03	0.44
PaO₂(mmHg)		69.25±10.72	66.40±7.59	0.24
PaCO₂(mmHg)		59.33±5.06	59.20±5.91	0.93
SaO₂ (%)		85.39±3.75	85.30±3.04	0.92
PCT(ng/L)		1.39±0.25	1.38±0.31	0.91
CRP(ng/L)		24.23±5.33	24.19±3.76	0.97
IL-6(pg/ml)		28.43±5.04	28.40±5.92	0.98
IL-8(pg/ml)		123.10±10.85	122.93±14.46	0.96
TNF-α(pg/ml)		29.67±5.01	30.23±5.04	0.66
6MWD(m)		298.67±81.56	298.63±75.14	1.00
CAT评分		34.63±2.33	34.23±2.49	0.52
mMRC评分		3.40±0.72	3.33±0.88	0.75
BNP(μg/L)		381.87±76.48	381.90±85.45	1.00
年累计住院次数(次/年)		4.47±0.73	4.13±0.82	0.10

临床资料		观察组(n＝30)	对照组(n＝30)	P值
年龄(岁)		67.47±9.56	67.8±8.92	0.83
性别[男(%)]		63.33(19)	60.00%(18)	0.79
	[女(%)]	36.67(11)	40.00(12)	0.80
RR(次/min)		21.47±1.41	21.3±1.84	0.70
HR(次/min)		84.87±5.27	83.53±5.44	0.34
pH		7.37±0.04	7.38±0.03	0.44
PaO₂(mmHg)		69.25±10.72	66.40±7.59	0.24
PaCO₂(mmHg)		59.33±5.06	59.20±5.91	0.93
SaO₂ (%)		85.39±3.75	85.30±3.04	0.92
PCT(ng/L)		1.39±0.25	1.38±0.31	0.91
CRP(ng/L)		24.23±5.33	24.19±3.76	0.97
IL-6(pg/ml)		28.43±5.04	28.40±5.92	0.98
IL-8(pg/ml)		123.10±10.85	122.93±14.46	0.96
TNF-α(pg/ml)		29.67±5.01	30.23±5.04	0.66
6MWD(m)		298.67±81.56	298.63±75.14	1.00
CAT评分		34.63±2.33	34.23±2.49	0.52
mMRC评分		3.40±0.72	3.33±0.88	0.75
BNP(μg/L)		381.87±76.48	381.90±85.45	1.00
年累计住院次数(次/年)		4.47±0.73	4.13±0.82	0.10

组　别	时间	PCT (ng/L)	CRP (mg/L)	IL-6 (pg/ml)	IL-8 (pg/ml)	TNF-α (pg/ml)
观察组	1月	1.39±0.25	24.23±5.33	28.43±5.04	123.10±10.85	29.67±5.01
	12月	0.17±0.06^ab	5.48±0.97^ab	6.80±1.59^ab	41.77±7.15^ab	10.62±1.48^ab
对照组	1月	1.38±0.31	24.19±3.76	28.40±5.92	122.93±14.46	30.23±5.04
	12月	0.75±0.15^a	10.85±1.85^a	15.12±1.88^a	85.73±12.00^a	15.60±2.33^a

组　别	时间	PCT (ng/L)	CRP (mg/L)	IL-6 (pg/ml)	IL-8 (pg/ml)	TNF-α (pg/ml)
观察组	1月	1.39±0.25	24.23±5.33	28.43±5.04	123.10±10.85	29.67±5.01
	12月	0.17±0.06^ab	5.48±0.97^ab	6.80±1.59^ab	41.77±7.15^ab	10.62±1.48^ab
对照组	1月	1.38±0.31	24.19±3.76	28.40±5.92	122.93±14.46	30.23±5.04
	12月	0.75±0.15^a	10.85±1.85^a	15.12±1.88^a	85.73±12.00^a	15.60±2.33^a

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