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. 2020 Oct 15;10(5):231-239.
eCollection 2020.

Comparison of efficacy between sequential ventilation and conventional invasive mechanical ventilation in the treatment of pulmonary hypertension complicated with respiratory failure

Yudan Zhu  1 , Kongliang Ke  1 , Zhi Dai  2 , Hongqin Tang  3 , Qiannan Xu  3 , Tinglin Guo  1 , Chongling Sang  4
Affiliations

Comparison of efficacy between sequential ventilation and conventional invasive mechanical ventilation in the treatment of pulmonary hypertension complicated with respiratory failure

Yudan Zhu et al. Am J Blood Res. .

Abstract

Objective: Pulmonary hypertension (PAH) is a serious progressive and fatal pulmonary disease characterized by elevated pulmonary artery pressure. Mechanical sequential ventilation has been gradually applied in the treatment of patients with PAH complicated with RF, which can effectively reduce the incidence of VAP and better promote the recovery of respiratory function. This study is aimed to determine the efficacy of sequential ventilation and conventional invasive mechanical ventilation in the treatment of pulmonary hypertension (PAH) complicated with respiratory failure (RF).

Methods: A total of 198 patients with both PAH and RF admitted to our hospital were enrolled. Among them, 102 patients were treated with sequential ventilation as a study group (stu group), and 96 patients were treated with conventional invasive mechanical ventilation as a control group (con group). Then the two groups were compared in efficacy and related indexes before and after treatment.

Results: The stu group experienced significantly shorter invasive ventilation time, total mechanical ventilation time, and hospitalization time than the con group (all P<0.05), and showed a significantly lower complication rate than the con group (P<0.05). The reintubation rate, weaning failure rate, and ventilator-associated pneumonia (VAP) rate of the stu group were all significantly lower than those of the con group (all P<0.05), and the stu group showed significantly higher pondus hydrogenii (pH) and arterial partial pressure of oxygen (PaO2) and significantly lower arterial carbondioxide partial pressure (PaCO2) than the con group after treatment (all P<0.05). Additionally, after treatment, the level of brain natriuretic peptide (BNP) and pulmonary artery pressure in both groups declined significantly (P<0.05), and the decline of them in the stu group was more significant than that in the con group (P<0.05). Moreover, after treatment, endothelin (ET) and angiotensin II (Ang II) in both groups declined significantly, and the decline of them in the stu group was also more significant than that in the con group (P<0.05).

Conclusion: Compared with conventional invasive mechanical ventilation, sequential ventilation can effectively minimize the treatment time of patients with PAH complicated with RF, reduce the incidences of adverse events and complications in them, and significantly improve the blood gas analysis indexes and BNP in them, so it is worthy of clinical promotion.

Keywords: Sequential ventilation; brain natriuretic peptide; conventional invasive mechanical ventilation; pulmonary hypertension; respiratory failure.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Comparison of treatment time between the two groups. A. The invasive ventilation time consumed by the study group was significantly shorter than that consumed by the control group. B. The total mechanical ventilation time consumed by the study group was significantly shorter than that consumed by the control group. C. The hospitalization time consumed by the study group was significantly shorter than that consumed by the control group. * indicates that in comparison between the two groups, P<0.05.
Figure 2
Figure 2
Comparison of the incidence of adverse events between the two groups. A. The weaning failure rate of the study group was significantly lower than that of the control group. B. The reintubation rate of the study group was significantly lower than that of the control group. C. The VAP rate of the study group was significantly lower than that of the control group. * indicates that in comparison of the two groups, P<0.05.
Figure 3
Figure 3
Comparison of blood gas analysis indexes between the two groups before and after treatment. A. Before treatment, there was no notable difference between the two groups in pH, while after treatment, pH of the study group was significantly higher than that of the control group. B. Before treatment, there was no notable difference between the two groups in PaO2, while after treatment, PaO2 of the study group was significantly higher than that of the control group. C. Before treatment, there was no notable difference between the two groups in PaCO2, while after treatment, PaCO2 of the study group was significantly lower than that of the control group. a indicates that in comparison of the same group before and after treatment, aP<0.05. b indicates that in comparison with the study group after treatment, bP<0.05.
Figure 4
Figure 4
Comparison of BNP between the two groups before and after treatment. Before treatment, there was no significant difference between the two groups in BNP, while after treatment, BNP in both groups decreased significantly, and BNP in the study group was significantly lower than that in the control group. a indicates that in comparison of the same group before and after treatment, aP<0.05. b indicates that in comparison with the study group after treatment, bP<0.05.
Figure 5
Figure 5
Comparison of pulmonary artery pressure between the two groups before and after treatment. Before treatment, there was no significant difference between the two groups in pulmonary artery pressure, while after treatment, pulmonary artery pressure in both groups decreased significantly, and pulmonary artery pressure in the study group was significantly lower than that in the control group. a indicates that in comparison of the same group before and after treatment, aP<0.05. b indicates that in comparison with the study group after treatment, bP<0.05.
Figure 6
Figure 6
Comparison of ET and Ang II between the two groups before and after treatment. A. Before treatment, there was no notable difference between the two groups in ET, while after treatment, ET of both groups decreased significantly, and ET of the study group was significantly lower than that of the control group. B. Before treatment, there was no notable difference between the two groups in Ang II, while after treatment, Ang II of both groups decreased significantly, and Ang II of the study group was significantly lower than that of the control group. a indicates that in comparison of the same group before and after treatment, aP<0.05. b indicates that in comparison with the study group after treatment, bP<0.05.
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