| Summary: | Background Noninvasive positive pressure ventilation (NPPV) is a major respiratory support technique for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and carbon dioxide (CO2) retention. However, the obvious dead space in available masks used for NPPV could easily lead to repeated CO2 inhalation, which affects the correction of CO2 retention. Objective To develop a face mask with two channel and constant leakage (TCCL) used for NPPV, and to examine its value in NPPV treatment of AECOPD patients with CO2 retention. Methods Thirty patients with AECOPD and typeⅡ respiratory failure treated with NPPV were recruited from the ICU, the First Affiliated Hospital of Chongqing Medical University from 2020 to 2021, and equally randomized into an experimental group (using the TCCL mask) and an control group (using the traditional mask with an exhalation valve on the side for NPPV) . Treatment effectiveness was assessed using arterial partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) monitored at baseline, and at the end of 4, 8, 24, and 48 hours of NPPV treatment as well as 24 hours after NPPV cessation. Results The two-way repeated measures ANOVA indicated that treatment time and treatment approach had no interactive effects on PaO2 (P>0.05) . Treatment time produced significant main effects on PaO2 (P<0.001) , while treatment approach did not (F=0.153, P=0.699) . In both groups, the level of PaO2 at baseline was lower than that at the end of 4, 8, 24, and 48 hours of NPPV treatment and 24 hours after NPPV cessation (P<0.05) ; the level of PaO2 at the end of 4 hours of treatment was lower than that measured at the subsequent four time points (P<0.05) ; the PaO2 level at the end of 8 hours of treatment was lower than that at 48 hours of treatment and 24 hours after NPPV cessation (P<0.05) . The PaO2 level at 24 hours of treatment was lower than that at 48 hours of treatment in the control group (P<0.05) . The PaO2 level at 24 hours of treatment was lower than that at 48 hours of treatment and 24 hours after NPPV cessation in the experimental group (P<0.05) . But there was no significant difference in PaO2 level measured at each time point between the groups (P>0.05) . Treatment time and treatment approach had no interactive effects on PaCO2 (P>0.05) . Treatment time produced significant main effect on PaCO2 (P<0.001) , treatment approach also exerted obvious effect on it (F=5.129, P=0.031) . Compared with the control group, the experimental group demonstrated lower PaCO2 levels at the end of 4, 8 and 24 hours of treatment (P<0.05) . In both groups, the PaCO2 level at baseline was higher than that at the end of 4, 8, 24, and 48 hours after NPPV treatment and 24 hours after NPPV cessation (P<0.05) . The PaCO2 level at the end of 4 hours of treatment was higher than that measured at the subsequent four time points (P<0.05) . The PaCO2 level at the end of 8 hours of treatment was higher than that measured at the subsequent three time points (P<0.05) . The PaCO2 level of the control group at 24 hours of treatment was higher than that at 48 hours of treatment and 24 hours after NPPV cessation (P<0.05) . The PaCO2 level in the experimental group at 24 or 48 hours of treatment was higher than that at 24 hours after NPPV cessation. Conclusion TCCL mask may contribute to rapid correction of CO2 retention and effective improvement of oxygenation in AECOPD patients.
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