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- W2349076543 abstract "Objective To evaluate the feasibility of acute physiology and chronic health evaluation(APACHE) Ⅱ and APACHE Ⅲ score as the indications for invasive and noninvasive mechanical ventilation in chronic obstructive pulmonary disease(COPD) exacerbations.Methods 112 COPD patients with acute exacerbation of COPD complicated by hypercapnic respiratory failure were enrolled in the study and randomized to receive either oxygen therapy(oxygen group) or bi-level positive airway pressure ventilation(BiPAP group) based on routine therapy.According to the therapeutic effect,the two groups were divided into four subgroups,ie. oxygen effective group,oxygen failure group(need NIPPV),BiPAP effective group and invasive ventilation group.The APACHE Ⅱ and APACHE Ⅲ scores of each group were counted respectively.Results The APACHE Ⅱ and APACHE Ⅲ scores of invasive ventilation group were 30.5±3.4 and 75.3±12.4 respectively,significantly higher than those of other groups.The hospital stay of the BiPAP group was significantly shorter than that of the oxygen group.Further analysis showed the difference of hospital stay (8.50±2.11)d vs (13.65±2.54)d,(10.38±1.53)d vs (14.20±2.31)d,both P0.001 was mainly seen in the patients with higher APACHE Ⅱ score patients(16～20,21～25),not in the patients with low APACHE Ⅱscore(15) (6.29±1.82)d vs(6.93±1.77)d,P0.05).ROC analysis showed that the NIV was likely to fail when APACHE Ⅱ score 26 or APACHE Ⅲ 61 with sensitivity of 88.6 and 96.8,and specificity of 100 and 84.0,respectively. It also showed that pH value 7.25 and PaCO_2 85 mm Hg predicted a poor outcome of noninvasive ventilation with the sensitivity of 88.8 and 75.0,and specificity of 85.0 and 82.5,respectively.Conclusions For moderate AECOPD patients with APACHE Ⅱ score range from 16 to 25,early introduction of BiPAP could shorten the hospital stay significantly,but for patients with APACHE Ⅱ score below 15,obvious benefit of BiPAP was not found.APACHE Ⅱ score 26 or APACHE Ⅲ61 could be indicators for invasive ventilation." @default.
- W2349076543 created "2016-06-24" @default.
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- W2349076543 date "2006-01-01" @default.
- W2349076543 modified "2023-09-28" @default.
- W2349076543 title "The application of acute physiology and chronic health evaluation scoring system in chronic obstructive pulmonary disease exacerbation" @default.
- W2349076543 hasPublicationYear "2006" @default.
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