Effect of bronchial lavage combined with non-invasive positive pressure ventilation on treatment of typeⅡrespiratory failure in elderly patients with chronic obstructive pulmonary disease

Objective: To investigate the effect of bronchial lavage combined with non-invasive positive pressure ventilation(NIPPV) on treatment of typeⅡ respiratory failure in elderly Patients with chronic obstructive pulmonary disease (COPD). Methods: COPD patients with more sputum(≥ 50 ml/d) were randomly divided into treatment group(56 cases) and control group(58 cases). Patients in treatment groups received fiberoptic bronchoscopy (FOB) under care after rescue equipments were prepared. According to the standard procedures of FOB,secretions were suctioned from the airway,then the airway was washed repeatedly until the secretions were removed completely. After bronchial lavage,these patients received NIPPV through the face shield. If the amount of sputa increased in the second or third day,the bronchial lavage would be repeated. Patients in the control group received only NIPPV. Results: After first bronchial lavage,the PaO₂ increased significantly in treatment group,while PaCO₂ decreased significantly(P < 0.01). In 42 cases,PaO₂ had no obvious increase after the second BAL(P > 0.05) while PaCO₂ had obvious decline(P < 0.01). PaO₂ increased significantly after NIPPV(P < 0.01),while PaO₂ decreased in control group(P < 0.01). In treatment group,49 cases(87.5%) were cured; 7 cases had to receive invasive mechanical ventilation; In control group,42 cases(72.4%) were cured. There was significant difference between the two groups(P < 0.05). The durations of non-invasive mechanical ventilation and hospitalization were shorten obviously in treatment group than in control group. Hospital charges decreased obviously in treatment group(P < 0.01). Conclusions: The bronchial lavage combined with NIPPV is safe and effective treatment for elderly Patients with COPD and is a method worthy of further study.