Clinical Application of a Novel Noninvasive Positive Pressure Ventilation Face Mask with Two Channels and Constant Leakage for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Carbon Dioxide Retention

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 easil...

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Main Author: HUANG Tao, LUO Na, LUO Song, XU Qin
Format: Article
Language:zho
Published: Chinese General Practice Publishing House Co., Ltd 2023-01-01
Series:Zhongguo quanke yixue
Subjects:
Online Access:https://www.chinagp.net/fileup/1007-9572/PDF/zx2021120282.pdf
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author HUANG Tao, LUO Na, LUO Song, XU Qin
author_facet HUANG Tao, LUO Na, LUO Song, XU Qin
author_sort HUANG Tao, LUO Na, LUO Song, XU Qin
collection DOAJ
description 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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spelling doaj.art-bdbe0f12dbd74114bb9634010c50dcd12024-04-09T07:01:23ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722023-01-01260334334710.12114/j.issn.1007-9572.2022.0088Clinical Application of a Novel Noninvasive Positive Pressure Ventilation Face Mask with Two Channels and Constant Leakage for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Carbon Dioxide RetentionHUANG Tao, LUO Na, LUO Song, XU Qin01.ICU, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China;2.Medical Data Science Academy, Chongqing Medical University, Chongqing 400016, China;3.Department of General Medicine, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, ChinaBackground 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.https://www.chinagp.net/fileup/1007-9572/PDF/zx2021120282.pdfpulmonary disease, chronic obstructive|lung diseases|respiratory failure|mask|blood gas analysis|positive-pressure respiration|patent|treatment outcome|noninvasive positive pressure
spellingShingle HUANG Tao, LUO Na, LUO Song, XU Qin
Clinical Application of a Novel Noninvasive Positive Pressure Ventilation Face Mask with Two Channels and Constant Leakage for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Carbon Dioxide Retention
Zhongguo quanke yixue
pulmonary disease, chronic obstructive|lung diseases|respiratory failure|mask|blood gas analysis|positive-pressure respiration|patent|treatment outcome|noninvasive positive pressure
title Clinical Application of a Novel Noninvasive Positive Pressure Ventilation Face Mask with Two Channels and Constant Leakage for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Carbon Dioxide Retention
title_full Clinical Application of a Novel Noninvasive Positive Pressure Ventilation Face Mask with Two Channels and Constant Leakage for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Carbon Dioxide Retention
title_fullStr Clinical Application of a Novel Noninvasive Positive Pressure Ventilation Face Mask with Two Channels and Constant Leakage for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Carbon Dioxide Retention
title_full_unstemmed Clinical Application of a Novel Noninvasive Positive Pressure Ventilation Face Mask with Two Channels and Constant Leakage for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Carbon Dioxide Retention
title_short Clinical Application of a Novel Noninvasive Positive Pressure Ventilation Face Mask with Two Channels and Constant Leakage for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Carbon Dioxide Retention
title_sort clinical application of a novel noninvasive positive pressure ventilation face mask with two channels and constant leakage for patients with acute exacerbation of chronic obstructive pulmonary disease and carbon dioxide retention
topic pulmonary disease, chronic obstructive|lung diseases|respiratory failure|mask|blood gas analysis|positive-pressure respiration|patent|treatment outcome|noninvasive positive pressure
url https://www.chinagp.net/fileup/1007-9572/PDF/zx2021120282.pdf
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