[Clinical analysis of value of different modes of respiratory support in the treatment of critical patients].
OBJECTIVE
To investigate the relationship between the successful results with different methods and time of initiation of respiratory support in critically ill patients.


METHODS
The clinical data of 458 critical care patients were reviewed and analyzed. Among the patients, there were 47 cases of cardio-pulmonary resuscitation, 105 cases of acute airway obstruction, 156 cases of acute respiratory failure, and 150 cases of chronic respiratory failure. Intubation, or tracheostomy, or non-invasive positive pressure ventilation (NPPV) at different times and occasions were performed in the patients.


RESULTS
One hundred and seventeen cases (25.5%) died during the respiratory support treatment, 49 cases gave up the treatment, and 292 patients (63.8%) were cured after mechanical ventilation. As the success rate was the lowest in patients who survived cardio-pulmonary resuscitation (21.3%, 10/47), it was higher in acute respiratory failure (55.1%, 86/156), and the best result (82.8%, 87/105) was obtained in the acute airway obstruction group and patients with chronic respiratory failure (72.7%, 109/150). In the group of patients undergoing early respiratory support, the cure rate was 95.0% (57/60) in patients with invasive method, and 95.5% (21/22) in the NPPV group. The result was significantly different compared with that of later treatment group [81.7% (68/82) in invasive group, and 60.9% (2/29) in NPPV group, both P<0.01]. It demonstrated that the earlier the respiratory support was given the better results. If the respiratory support was delayed, cure rate was significantly reduced [65.6% (63/96) in invasive group and 48.1% (13/27) in NPPV group, both P<0.01]. The cure rate was no difference between different modes of respiratory support between early treatment groups, however, invasive respiratory support was much better than NPPV [44.4% (40/90) and 0 (0/5)] when instituted in the late stages (all P<0.01).


CONCLUSIONS
It is of prime importance to ensure optimal ventilation in the early stage of diseases, the difficulty and risk of establishment of a patent airway are main problems in the treatment of critically ill patients.
Department of Respiratory Disease, Lanzhou General Hospital, Lanzhou 730050, Gansu, China. yunkuizhu@yahoo.com.cn
Yun-kui
YK
Zhu
Yue-bin
YB
Xu
Ji-dong
JD
Li
Shu
S
Wang
Yong-jiu
YJ
Xiao
Zhe
Z
Wei
Du-jiao
DJ
Liu
Wei
W
Liu
Qing-liang
QL
Xue
Xiao-feng
XF
Zhou
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016638:Critical Illness; D005260:Female; D005392:First Aid; D006801:Humans; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000379:methods*; D012131:Respiratory Insufficiency / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult