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      An Analysis of the Effect of Noninvasive Positive Pressure Ventilation on Patients with Respiratory Failure Complicated by Diabetes Mellitus

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      , , ,
      Disease Markers
      Hindawi

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          Abstract

          Objective

          To observe the clinical effectiveness of noninvasive positive pressure ventilation in patients with respiratory failure complicated by diabetes.

          Methods

          From May 2021 to May 2022, 90 patients with respiratory failure complicated by diabetes treated in our hospital were recruited and randomly assigned to receive either medication (control group) or noninvasive positive pressure ventilation (study group), with 45 patients in each group. The clinical endpoint was therapeutic outcomes.

          Results

          Noninvasive positive pressure ventilation resulted in significantly lower Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores versus medications ( P < 0.05). Patients with noninvasive positive pressure ventilation showed better pulmonary function indices versus those with medications ( P > 0.05). There was no significant difference in arterial oxygen (PaO 2), carbon dioxide partial pressure (PaCO 2), and arterial oxygen pressure/inspired fraction of O 2 (PaO 2/FiO 2) between the two groups prior to the intervention ( P > 0.05). However, patients in the study group had significantly elevated PaO 2 and PaO 2/FiO 2 and lower PaCO 2 levels than those in the control group ( P < 0.05). Following the intervention, noninvasive positive pressure ventilation resulted in significantly lower inflammatory factor levels versus medications ( P > 0.05). After the intervention, markedly better glucose control was observed in the study group versus the control group ( P < 0.05). The incidence of complications in the control group was 2.38%, which was significantly lower than that of the control group (16.67) ( P < 0.05).

          Conclusion

          Noninvasive positive pressure ventilation effectively suppresses the inflammatory response, improves the blood gas analysis index, and eliminates the negative emotions of patients, thereby maintaining hemodynamic stability and improving clinical efficacy with a better safety profile. Further studies are recommended prior to clinical promotion.

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          Most cited references24

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          High flow nasal cannulae oxygen therapy in acute-moderate hypercapnic respiratory failure

          Severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a significant event that results in substantial mortality.
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            Domiciliary High-Flow Nasal Cannula Oxygen Therapy for Patients with Stable Hypercapnic Chronic Obstructive Pulmonary Disease. A Multicenter Randomized Crossover Trial

            A growing evidence base suggests a benefit of using high-flow nasal cannula oxygen therapy in the acute setting. However, the clinical benefit of domiciliary use of high-flow nasal cannula oxygen therapy in patients with chronic hypercapnic respiratory failure due to chronic obstructive pulmonary disease remains unclear.
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              Reductions in dead space ventilation with nasal high flow depend on physiological dead space volume: metabolic hood measurements during sleep in patients with COPD and controls

              Nasal high flow (NHF) reduces minute ventilation and ventilatory loads during sleep but the mechanisms are not clear. We hypothesised NHF reduces ventilation in proportion to physiological but not anatomical dead space. 11 subjects (five controls and six chronic obstructive pulmonary disease (COPD) patients) underwent polysomnography with transcutaneous carbon dioxide (CO 2 ) monitoring under a metabolic hood. During stable non-rapid eye movement stage 2 sleep, subjects received NHF (20 L·min −1 ) intermittently for periods of 5–10 min. We measured CO 2 production and calculated dead space ventilation. Controls and COPD patients responded similarly to NHF. NHF reduced minute ventilation (from 5.6±0.4 to 4.8±0.4 L·min −1 ; p<0.05) and tidal volume (from 0.34±0.03 to 0.3±0.03 L; p<0.05) without a change in energy expenditure, transcutaneous CO 2 or alveolar ventilation. There was a significant decrease in dead space ventilation (from 2.5±0.4 to 1.6±0.4 L·min −1 ; p<0.05), but not in respiratory rate. The reduction in dead space ventilation correlated with baseline physiological dead space fraction (r 2 =0.36; p<0.05), but not with respiratory rate or anatomical dead space volume. During sleep, NHF decreases minute ventilation due to an overall reduction in dead space ventilation in proportion to the extent of baseline physiological dead space fraction.
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                Author and article information

                Contributors
                Journal
                Dis Markers
                Dis Markers
                DM
                Disease Markers
                Hindawi
                0278-0240
                1875-8630
                2022
                14 October 2022
                : 2022
                : 3597200
                Affiliations
                Department of Emergency, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, China
                Author notes

                Academic Editor: Xiaotong Yang

                Author information
                https://orcid.org/0000-0001-9865-9556
                Article
                10.1155/2022/3597200
                9586794
                36277980
                5da7701b-5312-4668-aa28-15aa722e52ed
                Copyright © 2022 Jia-an Sun et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 July 2022
                : 10 September 2022
                Categories
                Research Article

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