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首页> 外文期刊>Intensive care medicine >Changes in the practice of non-invasive ventilation in treating COPD patients over 8 years.
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Changes in the practice of non-invasive ventilation in treating COPD patients over 8 years.

机译：过去8年中，无创通气治疗COPD患者的做法发生了变化。

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OBJECTIVE. We reviewed data of 208 episodes of acute respiratory failure due to chronic obstructive pulmonary disease treated by non-invasive ventilation (NIV) in our Respiratory Intensive Care Unit (RICU) from its opening in 1992 to 1999. MATERIAL AND METHODS. We assessed whether the rate of NIV success, the severity of the disease, and the associated costs changed in this period during which the staff and the equipment did not change. RESULTS. The failure rate was constant over the years (17.2% on average). The severity of the episodes of ARF, defined by pH and APACHE II at admission, worsened during the years. The statistical change point test allowed us to identify 1997 as the year of a significant change in the severity of admission pH and therefore to identify two different periods: 1992-1996 (mean pH = 7.25+/-0.07) and 1997-1999 (7.20+/-0.08; P<0.001). In this latter period the risk of failure for a patient with a pH <7.25 was threefold lower than in 1992-1996. In 1997-1999 an increasing number of episodes of ARF with a pH >7.28 were treated in the Medical Ward (20% vs 60%). This allowed a significant reduction of daily cost per patient treated with NIV (558+/-8 Euros vs 470+/-14 Euros, respectively; P<0.01). CONCLUSIONS. We conclude that, over time, experience with NIV may progressively allow more severely ill patients to be treated without changing the rate of success. The daily cost of NIV per patient can be reduced by treating less severely ill patients outside the RICU.
机译：目的。我们回顾了我们的呼吸加护病房（RICU）自1992年至1999年开业以来通过无创通气（NIV）治疗的208例由于慢性阻塞性肺疾病导致的急性呼吸衰竭的数据。材料和方法。我们评估了NIV成功率，疾病严重程度以及相关费用在此期间员工和设备没有变化的时间是否发生了变化。结果。多年来的故障率是恒定的（平均为17.2％）。这些年来，由入院时的pH和APACHE II定义的ARF发作的严重程度在恶化。通过统计变化点检验，我们可以将1997年确定为入院pH值严重变化的年份，因此可以确定两个不同的时期：1992-1996年（平均pH值= 7.25 +/- 0.07）和1997-1999年（7.20） +/- 0.08; P <0.001）。在后一个时期，pH <7.25的患者失败的风险比1992-1996年降低了三倍。在1997-1999年，在医疗病房中治疗了越来越多的pH> 7.28的ARF（20％vs 60％）。这可以显着降低每位接受NIV治疗的患者的每日费用（分别为558 +/- 8欧元和470 +/- 14欧元; P <0.01）。结论。我们得出的结论是，随着时间的流逝，NIV的经验可能会逐步允许对重症患者进行治疗，而不会改变成功率。通过在RICU以外治疗病情较轻的患者，可以降低每位患者的NIV每日费用。

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