Clinical Application of Adaptive Support Ventilation in Stable Chronic Obstructive Pulmonary Disease Patients on Long Term Ventilation and Nursing Strategy

Objective To study the clinical application of adaptive support ventilation(ASV) in stable chronic obstructive pulmonary disease(COPD) patients on long term ventilation and nursing strategy.Methods Eleven elderly patients with stable COPD(on long term ventilation) were selected for this study from Jan 2004 to Mar 2005.Control mechanical ventilation(CMV,tidal volume being 7~9 ml·kg~(-1)·min~(-1),respiratory rate being 16~18/min) and ASV were used for the patients separately.The variables of respiratory mechanics were recorded 30 min after the respiration and heart rate became stable.Meanwhile,the variables of hemodynamics(heart rate and blood pressure) and arterial blood analysis were measured after 2 modes of ventilation.The patients received good psychological nursing before they were put on ASV.During the ASV,the airways of patients were kept open;the artificial airways were well fixed,humidified;and the sputum was aspirated.Results Compared with CMV,ASV had an increased tidal volume and decreased respiratory rate;meanwhile,inspiratory flow,inspiratory time constants,and expiratory time constants were also higher after receiving ASV(P0.05);the expiratory flow was lower after receiving ASV(P0.05);the airway peak pressure,mean airway pressure,inspiratory resistance,and expiratory resistance had no change(P0.05).Patients felt more comfortable after they received ASV.Conclusion ASV can be safely applied in patients with stable COPD,with less respiratory effort and better good tolerance.