Efficacy of BiPAP non-invasive ventilator in the treatment and cure of acute exacerbation of pulmonary heart disease and its effects on serum NT-proBNP, arterial blood gas indicators and pulmonary function

doi:10.3877/cma.j.issn.1674-6902.2023.01.002

Abstract

Abstract:

Objective

To evaluate the efficacy of bilevel positive airway pressure (BiPAP) non-invasive ventilator in the treatment of acute exacerbation of chronic pulmonary heart disease (CPHD), and to analyze its effects on serum N-terminal pro-brain natriuretic peptide (NT-proBNP), arterial blood gas indicators and pulmonary function.

Methods

154 patients with acute exacerbation of CPHD who were treated in West China Hospital, Sichuan University from January 2019 to December 2021 were selected as the research subjects, and they were divided into control group 74 cases and observation group 80 cases by the remainder grouping method of the random number table method. The control group was given conventional treatments such as anti-infection, oxygen therapy, diuretic therapy and cardiotonic therapy, while the observation group was given BiPAP ventilator adjuvant therapy on the basis of the non-BiPAP group, with 7 days as a course of treatment. The clinical efficacy of the two groups of patients was recorded, and the serological indicators NT-proBNP, sST2 and arterial blood gas indicators PaO₂, PaCO₂, pH before treatment, after 3 days of treatment and after 7 days of treatment as well as cardiac function indicators LVEF, CI and pulmonary function indicators FEV₁, FVC, PEF% before treatment and after 7 days of treatment were compared.

Results

The total effective rate in observation group was significantly higher than that in control group (95.0% vs. 87.84%, P<0.05). There were significant interaction effects in serum NT-proBNP, sST2 and PaO₂, PaCO₂ and pH in both groups of patients before and after treatment (all P<0.05). After treatment, the levels of serum NT-proBNP, sST2 and PaCO₂ in observation group were decreased to (1, 983.41±204.35) pg/ml, (244.69±48.62) ng/L and (47.96±4.12) mmHg after 7 days of treatment, and the levels in control group were reduced to (2, 447.39±241.28) pg/ml, (281.85±50.33) ng/L and (50.05±3.81) mmHg, and the levels in observation group were lower compared with those in control group after treatment (P<0.05). The PaO₂ and pH in observation group were increased to (69.88±4.22) mmHg and (7.40±0.03) after 7 days of treatment, and the two indicators in control group were increased to (66.21±5.71) mmHg and (7.37±0.04), and the indicators in observation group after treatment were higher than those in control group (P<0.05). The LVEF, CI, FEV₁, FVC and PEF% in observation group were increased to (58.29±5.22)%, (2.78±0.49) ml/(min·m²), (0.97±0.16) L, (1.89±0.31) L and (58.44±4.97)% after 7 days of treatment, and the indicators in control group were enhanced to (54.14±4.76)%, (2.46±0.42) ml/(min·m²), (0.88±0.15) L, (1.71±0.27)L and (53.06±5.12)% after 7 days of treatment, and the indicators were higher in observation group than those in control group after treatment (P<0.05).

Conclusion

BiPAP non-invasive ventilator for the treatment of acute exacerbation of CPHD can significantly improve the cardiopulmonary function, and it has a significant efficacy and has certain clinical value.

Key words: Chronic pulmonary heart disease, Acute exacerbation, Bilevel positive airway pressure, Cardiac function, Pulmonary function

Juan Zou, Yuqing Liu, Yuanyuan Wan. Efficacy of BiPAP non-invasive ventilator in the treatment and cure of acute exacerbation of pulmonary heart disease and its effects on serum NT-proBNP, arterial blood gas indicators and pulmonary function[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2023, 16(01): 6-10.

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Figures/Tables 4

References 29

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组　别	例数	NT-proBNP(pg/ml)			sST2(ng/L)
组　别	例数	治疗前	治疗3 d	治疗7 d	治疗前	治疗3 d	治疗7 d
观察组	80	5 976.24±1 049.57	3 962.55±694.08^a	1 983.41±204.35^ab	587.44±98.36	395.28±65.19^a	244.69±48.62^ab
对照组	74	5 898.83±997.46	4 489.18±712.30^a	2 447.39±241.28^ab	579.83±101.27	436.11±71.03^a	281.85±50.33^ab
t值		0.469	4.647	12.877	0.473	3.716	4.660
P值		0.640	0.000	0.000	0.637	0.000	0.000

组　别	例数	NT-proBNP(pg/ml)			sST2(ng/L)
组　别	例数	治疗前	治疗3 d	治疗7 d	治疗前	治疗3 d	治疗7 d
观察组	80	5 976.24±1 049.57	3 962.55±694.08^a	1 983.41±204.35^ab	587.44±98.36	395.28±65.19^a	244.69±48.62^ab
对照组	74	5 898.83±997.46	4 489.18±712.30^a	2 447.39±241.28^ab	579.83±101.27	436.11±71.03^a	281.85±50.33^ab
t值		0.469	4.647	12.877	0.473	3.716	4.660
P值		0.640	0.000	0.000	0.637	0.000	0.000

组　别	例数	PaO₂(mmHg)			PaCO₂(mmHg)			pH
组　别	例数	治疗前	治疗3 d	治疗7 d	治疗前	治疗3 d	治疗7 d	治疗前	治疗3 d	治疗7 d
观察组	80	54.49±4.08	64.92±5.17^a	69.88±4.22^ab	67.22±3.98	52.48±4.75^a	47.96±4.12^ab	7.29±0.04	7.36±0.05^a	7.40±0.03^ab
对照组	74	55.12±3.62	62.07±4.63^a	66.21±5.71^ab	66.44±3.53	58.33±4.09^a	50.05±3.81^ab	7.30±0.03	7.34±0.04^a	7.37±0.04^ab
t值		1.014	3.603	4.536	1.287	8.189	3.268	1.755	2.741	5.265
P值		0.312	0.001	0.000	0.200	0.000	0.002	0.081	0.007	0.000

组　别	例数	PaO₂(mmHg)			PaCO₂(mmHg)			pH
组　别	例数	治疗前	治疗3 d	治疗7 d	治疗前	治疗3 d	治疗7 d	治疗前	治疗3 d	治疗7 d
观察组	80	54.49±4.08	64.92±5.17^a	69.88±4.22^ab	67.22±3.98	52.48±4.75^a	47.96±4.12^ab	7.29±0.04	7.36±0.05^a	7.40±0.03^ab
对照组	74	55.12±3.62	62.07±4.63^a	66.21±5.71^ab	66.44±3.53	58.33±4.09^a	50.05±3.81^ab	7.30±0.03	7.34±0.04^a	7.37±0.04^ab
t值		1.014	3.603	4.536	1.287	8.189	3.268	1.755	2.741	5.265
P值		0.312	0.001	0.000	0.200	0.000	0.002	0.081	0.007	0.000

组　别	例数	LVEF(%)		CI[ml/(min·m²)]
组　别	例数	治疗前	治疗7 d	治疗前	治疗7 d
观察组	80	42.91±4.33	58.29±5.22^a	1.51±0.29	2.78±0.49^a
对照组	74	43.15±4.02	54.14±4.76^a	1.54±0.31	2.46±0.42^a
t值		0.356	5.155	0.620	4.351
P值		0.722	0.000	0.536	0.000

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