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Chinese Hospital Says that Non-Invasive Positive Pressure Ventilation Without Intubation Significantly Increased Survival Rate of Respiratory Failure Patients

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  • Chinese Hospital Says that Non-Invasive Positive Pressure Ventilation Without Intubation Significantly Increased Survival Rate of Respiratory Failure Patients

    Rescue treatment and research in respiratory failure, a significant increase



    <center><table align="center"><tbody><tr><td></td></tr></tbody></table></center><center><table align="center"><tbody><tr><td></td></tr></tbody></table></center><center>
    首医大附属北京朝阳医院詹庆元
    The first Affiliated Beijing Chaoyang Hospital Medical Zhan Yuan

    </center>
    呼吸衰竭在临床极为常见,病死率较高,常见的急性低氧性呼吸衰竭平均为40&#37;,重症获得性肺炎为2 2%-70%,严重免疫力低下的患者更可高达50-90%。

    Very common in clinical respiratory failure, mortality high, common acute hypoxic respiratory failure in an average of 40%, severe acquired pneumonia of 22% -70%, severe immunocompromised patients can be as high 50-90%.
    呼吸衰竭的主要救治手段是呼吸支持技术。
    The main means of treatment of respiratory failure are respiratory support technology.
    首医大附属北京朝阳医院王辰教授等主持的“呼吸衰竭的发病机理与治疗研究”,做出了重要的科学与技术创新, 显著提高了对呼吸衰竭的治疗和研究水平。

    The first Affiliated Beijing Chaoyang Hospital, Medical Professor Wang Chen and so on under the auspices of "respiratory failure in the pathogenesis and treatment of research" and made important scientific and technological innovation, significantly improve the treatment of respiratory failure, and research level.


    其成果已在30个省市自治区的获得临床应用,并写入临床指南和教科书,成为行业技术标准;具有自主知识产权 的3种新型面罩获广泛应用,无创通气技术的临床应用被列入卫生部“面向农村和城市社区推广项目 ”。

    The results in 30 provinces and autonomous regions have access to clinical applications, and write clinical guidelines and textbooks, as the industry technical standards; with independent intellectual property rights of the three kinds of new masks have been widely used, non-invasive ventilation technology, clinical application has been included in the Health Department "for the rural and urban communities to promote the project."
    典型病例1
    Typical Case 1

    男性患者66岁,两年前确诊为多发性骨髓瘤,入院前一天发热、咳嗽、咳痰、呼吸愈加困难。
    Male patients 66 years old, two years ago, diagnosed as multiple myeloma, the day before admission, fever, cough, sputum, breathing more difficult.
    收入北京朝阳医院呼吸重症监护病房(RICU),诊断为重症肺炎合并I型呼吸衰竭。
    Revenue Beijing Chaoyang Hospital, respiratory intensive care unit (RICU), diagnosed as severe pneumonia-I respiratory failure.
    由于患者呼吸衰竭进展快,缺氧严重,传统做法是给予患者气管插管机械通气(有创通气,如图1所示)以改善缺 氧。
    In patients with respiratory failure due to rapid development, severe hypoxia, the traditional approach is to give patients with intubation and mechanical ventilation (invasive ventilation, as shown in Figure 1) to improve the anoxia.
    但这个患者患有多发性骨髓瘤,应用过大量化疗药物,身体免疫力低下,一旦插管后容易加重肺部感染,使治疗难 度加大。
    However, this patient suffered from multiple myeloma, applied over a large number of chemotherapy drugs, the body immunity is low, if intubation is easily increased lung infections, making treatment more difficult.
    医生选择了无创正压通气,不用插管,通过面罩给予患者正压通气辅助呼吸,改善缺氧(如图2所示 )。

    Doctors have chosen non-invasive positive pressure ventilation without intubation through the mask for positive pressure ventilation in patients with assisted breathing, improve oxygen (shown in Figure 2).
    最终好转出院。
    The final turn for the better discharge.

    无创通气早期干预呼吸衰竭,可有效地延缓呼吸衰竭的进展,避免气管插管,显著提高患者的生存率 。

    Non-invasive ventilation in respiratory failure and early intervention can effectively slow down the progress of respiratory failure, avoid endotracheal intubation, significantly increased the survival rate of patients.
    针对慢性阻塞性肺疾病(如慢性支气管炎、肺气肿等)的一项研究表明,当患者出现轻中度呼吸功能不全时,若不 给予及时干预,气管插管率高达15.2%;若在早期就应用无创通气方式,可使气管插管率降至4.7%,显著 减少了患者的痛苦和治疗费用。

    For chronic obstructive pulmonary diseases (such as chronic bronchitis, emphysema, etc.), a study shows that when patients with mild to moderate respiratory insufficiency, do not give a timely intervention, intubation rate was 15.2%; if Early on the application of non-invasive mechanical ventilation, endotracheal intubation can rate fell to 4.7%, significantly reduced the patient's suffering and treatment costs.

    典型病例2
    Typical Case 2

    男 性患者68岁,反复咳嗽、咳痰20余年,活动后气短4年,渐发展至上二楼便感呼吸困难,一个月前症状加重, 伴双下肢水肿,一周前咳嗽加重,咳黄脓痰,体温 最高39℃,一天前出现神志不清,转入北京朝阳医院重症监护病房,诊断为慢性阻塞性肺疾病、II型呼吸衰竭 、肺心病、肺性脑病。

    68-year-old male patients, repeated coughing, sputum more than 20 years after the event short of breath 4 years, first on the second floor will gradually develop a sense of breathing difficulties, a month before the symptoms get worse, with pairs of lower extremity edema, a week ago, increased cough, cough yellow Nong Tan, The maximum temperature 39 ℃, occurred one day before disorientation, transferred to Beijing Chaoyang Hospital intensive care unit, diagnosed as chronic obstructive pulmonary disease, II respiratory failure, pulmonary heart disease, pulmonary encephalopathy.
    在接受经口气管插管有创通气、加强气道痰液引流和抗感染治疗一周后,患者肺部感染得以控制,但此时自主呼吸 功能仍未完全恢复,尚不具备拔除气管插管的条件。
    In an interview with orotracheal intubation and invasive ventilation, to enhance airway sputum drainage and anti-infection treatment a week later, the patient to control lung infection, but respiratory function independently at this time have not yet fully restored, does not have the extubation of the conditions.
    朝阳医院的医生打破常规做法,早期拔除气管插管,改为无创通气,经过3天的治疗后,患者病情进一步好转,转 至普通病房。

    Chaoyang Hospital, doctors to break the routine practice of early extubation, conversion of non-invasive ventilation, after 3 days of treatment, patient's condition further improved, go to the general ward.



    有创机械通气的撤离是一个世界性难题。

    The withdrawal of invasive mechanical ventilation is a worldwide problem.
    传统的做法是:必须等至患者自主呼吸功能完全恢复才能拔管。
    The traditional approach is: We must wait until the complete functional recovery in patients with spontaneous breathing before extubation.
    这种做法往往会增加患者的插管时间,除了给患者带来较多的痛苦和医疗费用外,往往容易导致患者发生新一轮的 肺部感染(呼吸机相关性肺炎),增加患者的病死率,这在慢性呼吸功能不全患者尤其常见。
    This approach tends to increase the patient's intubation time, in addition to bringing more suffering for patients and health care costs, they often lead to a new round of patients with pulmonary infections (ventilator-associated pneumonia), increases patient died rate, which in patients with chronic respiratory insufficiency are especially common.
    朝阳医院的一项研究表明,应用有创-无创序贯机械通气的撤机策略治疗患者,可使有创机械通气时间缩短5天,住RICU时间显著缩短4天,呼吸机 相关肺炎的发生率由28%降至6%,住院病死率由16.2%降至2.1%。

    Chaoyang Hospital, a study shows that application of invasive - non-invasive mechanical ventilation weaning sequential treatment strategy for patients with invasive mechanical ventilation can reduce the time 5 days, living RICU significantly shorten the time 4 days, ventilator-associated pneumonia incidence of from 28% to 6%, hospital mortality from 16.2% to 2.1%.
    图片提供北京朝阳医院
    Photo courtesy of Beijing Chaoyang Hospital,

    王辰教授在呼吸重症监护病房指导治疗
    Professor Wang Chen in the respiratory intensive care unit to guide treatment

    经口气管插管行有创机械通气
    Orotracheal intubation OK invasive mechanical ventilation


  • #2
    Re: Chinese Hospital Says that Non-Invasive Positive Pressure Ventilation Without Intubation Significantly Increased Survival Rate of Respiratory Failure Patients

    This sounds like BIPAP, which is widely used in American ICU's. Bi-level Positive Airway Pressure (as opposed to CPAP--Constant Positive Airway Pressure), which a lot of people are familiar with because of its use for sleep apnea.

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