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[Mechanical ventilation therapy for aged patients with severe acute left heart failure combined with respiratory
Objective:
To sum up the clinical experience of mechanical ventilation in treatment of aged patients with severe left heart failure (ALVF) combined with acute respiratory failure (ARF).
Methods:
A retrospective analysis was carried out of the pattern, improvement rate, mortality, and complication of medical ventilation applied on 102 aged patients (82.0 9.9 yrs) with severe ALVF and ARF in the past 10 years. The data of the patients with ARF type I (42 cases) and the data of the patients with ARF type II (60 cases) were compared.
Results:
The route of mechanical ventilation in 102 patients (115 times) included administration of oxygen via nasal mask (18 times), nasal intubation (69 times) and oral intubation (29 times). The ventilation pattern included volume control (115 times), pressure control (25 times), CPAP (26 times), and PEEP (45 times). The improvement rates in the patients as a whole, group ARF-I, and group ARF-II were 60.8%, 69.0%, and 55.0% respectively (P < 0.05 between each two groups). The mortality rates in the patients as a whole, group ARF-I, and group ARF-II were 39.2%, 30.9%, and 45.0% respectively (P < 0.05). The complications ever found in all of the patients included arrhythmia (37.3%). Hypotension (35.3%), pulmonary infection (34.3%), bleeding of gastrointestinal tract (31.4%), acid0base unbalance (20.6), and pressure pneumothorax (2.9%). The clinical condition (severity, mortality, and complication rate) was more critical in group ARF-II than in group ARF-I.
Conclusion:
Mechanical ventilation is conducted with more difficulty and higher risk for aged patients with severe ALVF. However, while operated appropriately, it will be effective.