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Purpose of research:to explore a reasonable programmed withdrawal process of noninvasive ventilation and thereby reduce the duration of noninvasive mechanical ventilation in patients with acute exacerbations of chronic obstructive pulmonary disease.
This is a single-center, prospective, randomized controlled study. The study subjects were patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the intensive care unit, who were randomized into the study group, that is, the programmed withdrawal unit, and the control group was the traditional withdrawal unit (the attending physician decided the NIV regimen according to the condition). The primary study endpoints of the trial were complete evacuation of noninvasive ventilation (i. e. from the start of the patient to noninvasive ventilation) . Secondary study endpoints include length of stay in ICU, length of stay in hospital and failure of non-invasive ventilation (failure of non-invasive ventilation was defined as the patient underwent NIV again within 48 hours after being weaned off the ventilator;During NIV, endotracheal intubation was required, and invasive mechanical ventilation was used instead;The patient could not discontinue NIV completely and needed to use home non-invasive ventilation; The patient died.).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study group | Experimental | Programmed Weaning From Noninvasive Mechanical Ventilation |
|
| Control group | No Intervention | this is the traditional withdrawal unit (the attending physician will decide the NIV regimen according to the condition). |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Programmed Weaning From Noninvasive Mechanical Ventilation | Other | Programmed withdrawal unit: daily morning review arterial blood gas analysis (since the 2nd, daily morning stop non-invasive ventilation 1 hours, 2 hours, 3 hours, 4 hours after check arterial blood gas analysis), blood gas results suggest respiratory acidosis compensatory period (pH value greater than 7.35) can reduce daily noninvasive ventilation time, namely the noninvasive ventilation use time for 24 hours, 20 hours, the third day 16 hours, the fourth 12 hours, fifth day 8 hours. If ABG indicates still acid decompensation, continue the non-invasive ventilation regimen of the previous day. If noninvasive ventilation failed, invasive mechanical ventilation was performed. |
| Measure | Description | Time Frame |
|---|---|---|
| Complete evacuation time of non-invasive ventilation | from the start of the patient to the absence of noninvasive ventilation or return to the level of normal ventilation time for patients with non-invasive ventilation on a home non-invasive ventilator before acute exacerbation | At the end of non-invasive ventilation,through study completion, an average of 11 days |
| Measure | Description | Time Frame |
|---|---|---|
| Time in the ICU | from the start of the patient stay in ICU to the day leave from ICU | At the end of therapy in ICU,through study completion, an average of 14 days |
| length of stay | from the start of the patient stay in hospital to leave from hospital |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Qingtao Zhou | Peking University Third Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking University Third Hospita | Beijing | Beijing Municipality | 100191 | China |
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| At the end of therapy in hospital, through study completion, an average of 20 days |
| Failure rate of non-invasive ventilation | failure of non-invasive ventilation is defined as a patient requiring endotracheal intubation to invasive ventilation or death | At the end of therapy in hospital, an average of 20 days |