[A retrospective study on the treatment of patients with chronic obstructive pulmonary disease by face mask mechanical ventilation].
OBJECTIVE
To assess the effect and the influencing factors in face mask mechanical ventilation (FMMV) for the treatment of COPD with respiratory failure (RF), and to compare the efficacy and efficiency of FMMV with endotracheal intubation mechanical ventilation (ETMV).


METHODS
From 1991 to 2001, 4 ventilating periods were named initial, middle, late, and extending stage according to ventilators, face masks and mechanical ventilating methods. The results of FMMV in the 4 periods were compared. The results in patients with FMMV who reached the endotracheal intubation criteria were also compared with those in ETMV ones from 1988 to 1990.


RESULTS
385 patients with COPD and RF were admitted to RICU. The proportion of FMMV in all MV patients increased [48% (11/23), 79% (15/19), 85% (29/34), 91% (223/246)]; at the same time the effective rate of FMMV [46% (5/11), 67% (10/15), 83% (24/29), 89% (198/223)] and the total effective rate [71% (35/49), 71% (20/28), 81% (34/42), 88% (234/266)] also increased. 83 percent of the patients who suffered from severe disturbances of consciousness in the late and extending stage were successfully weaned from FMMV. Complications including the rates of nasal bridge erosion [27% (3/11), 13% (2/15), 7% (2/29), 2% (4/223)] and the rates of stomach distension [46% (5/11), 40% (6/15), 21% (6/29), 5% (11/223)] all decreased. The ventilation times and length of stay were significantly shorter than those in patients with ETMV. The rate of nosocomial pneumonia and the mortality of inpatients were significantly lower.


CONCLUSIONS
The ventilating techniques, ventilators and face masks were the main factors influencing FMMV results. FMMV could be used rationally for most COPD patients with RF as a valuable alternative to ETMV.
Zhu
Lei
L
Department of Pulmonology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Niu
Shan-fu
SF
Zhang
Shu-ping
SP
Xu
Xiao-wen
XW
Li
Shan-qun
SQ
Li
Yan-qin
YQ
Fang
Zhi-ye
ZY
Cai
Ying-yun
YY
Bai
Chun-xue
CX
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008397:Masks; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012121:Respiration, Artificial; D012189:Retrospective Studies