Objective: To discuss the optimal time for extubation and sequential non-invasive mechanical ventilation in COPD patients with exacerbated respiratory failure who received invasive ventilation.
Methods: 24 patients received invasive ventilation for 3 days were randomly assigned to receive noninvasive ventilation (study group) or to continue the weaning process with invasive ventilation (control group). The incidence of ventilator-associated pneumonia (VAP), the incidence of death, the duration of ventilation, the hospitalization were analyzed in two groups.
Results: Between study group and control group, the incidence of VAP was 0/12 vs 7/12, P = 0.027; the incidence of death was 0/12 vs 3/12, P = 0.217; the continued duration of ventilation after invasive ventilation for 3 days was (7 +/- 5) days vs (15 +/- 12) days, P < 0.05; the hospitalization was (16 +/- 6) days vs (25 +/- 12) days, P < 0.05, respectively.
Conclusions: In COPD patients with exacerbated respiratory failure who received invasive ventilation, invasive ventilation for 3 days followed by noninvasive ventilation may decrease the incidence of VAP, shorten the duration of ventilation and hospitalization.