Chronic Obstructive Pulmonary Disease
Conditions
Interventions
Group of HFNC:HFNC
Group of NPPV:NPPV
Sponsors
People's Hospital of Mianzhu
Eligibility
Sex/Gender
All
Age
18 Years to 85 Years
Inclusion criteria
Inclusion criteria: 1.Ages are greater than or equal to 18 years,and less than or equal to 85 years. 2.Meet the diagnostic criteria of AECOPD. 3.The duration of mechanical ventilation through Orotracheal intubation is greater than or equal to 36 hours. 4.Reaching the indication of off-line and passing spntaneus breathing trial(SBT). the indication of off-line: (1) The inducing factors that cause senescence are controlled effectively. (2) The patient's consciousness is clear, they can cooperate actively. (3) The patient's spontaneous breathing is restored and the support frequency is lowered to 10 times per minute. (4) The ventilatory function and oxygenation function of the patients were good:PaO2/FiO2 > 250mmHg, PEEP 7.35, PaCO2 and PaO2 are up to standard. (5) Hemodynamics were stable (systolic blood pressure was below 90 mmHg, mean arterial pressure was below 65 mmHg or systolic blood pressure was 20% lower than baseline systolic blood pressure), no Active Myocardial Ischemia, no use of pressor drug treatment or pressor drug dose is small.
Exclusion criteria
Exclusion criteria: 1. Plan to withdraw treatment within 48 hours. 2. Tracheotomy. 3. Patients with High Ridge myelopathy and neuromuscular diseases who may cause chronic aspiration dependence and/or require surgical intervention. 4. Severe Heart, brain, liver, kidney failure. 5. Severe malnutrition. 6. A serious and difficult-to-correct electrolyte disorder. 7. The patients have upper airway or facial injuries that make it impossible to wear a nasofacial mask. 8. The patients' cough reflex is very weak or the patients have no ability to expectorate. 9. There is a mechanical ventilation injury in this hospital. 10. There have been long-term noninvasive positive pressure ventilation, can not be offline before this admission.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| PH;PaCO2;PaO2;Oxygenation index;Respiratory comfort score of patients after tracheal catheter removal;Respiratory comfort score of patients 6h after tracheal catheter removal;Respiratory comfort score of patients 24 hours after tracheal catheter removal;Respiratory comfort score of patients 48 hours after tracheal catheter removal;Success rate of off-line invasive ventilator;rate of re-intubation within 48 hours;rate of re-intubation after 48 hours;length of stay in ICU;The total length of hospital stay;The total length of hospital stay; | — |
Countries
China
Contacts
Public ContactXiaodong Feng
People's Hospital of Mianzhu
Outcome results
None listed