Abstract:

[Abstract]   Objective   To investigate the various occasions of invasive mechanical ventilation in patients with acute
left heart failure.   Methods   Thirty-two patients with acute severe left heart failure were divided into two groups:17patients were treated with non- invasive mechanical ventilation (non- invasive mechanical ventilation group) and15patients were treated with invasive mechanical ventilation (invasive mechanical ventilation group). The respiratory rate (RR), arterial oxy?gen partial pressurep(O2), heart rate (HR) and mean arterial pressure (MAP) were observed after treatment for 0.5h,1h and3h in two groups of patients. The in-hospital mortality was compared between two groups.   Results   Ten patients of non-in?vasive mechanical ventilation group were in remission after0.5h,7cases without remission switched to endotracheal intubation for invasive mechanical. And 3of them were in remission in0.5~1h,4of them dead. Fourteen patients in invasive mechanical ventilation group were in remission after0.5h, one case was in remission after0.5~1h and no dead in this group.There were more patients in remission after0.5h in invasive mechanical ventilation group than those of non-invasive mechanical ventilation group (P=0.041). There were no significant differences in the number of patients in clinical remission after 0.5~1h and mortality between two groups. The values of RR and HR were decreased with the increasing treatment time in two groups. The values of p(O2) and MAP were increased with the increasing treatment time in two groups. There was a significantly lower RR at0.5h and1h in invasive mechanical ventilation group than that of non-invasive mechanical ventilation group (P<0.05). The values of p(O2) and MAP were significantly higher at 0.5h in invasive mechanical ventilation group than those of non-invasive mechanical ventilation group (P<0.05). The levels of HR at0.5h and3h were significantly lower in invasive mechanical ventilation group than those of non-invasive mechanical ventilation group (P<0.05).    Conclusion     Invasive mechanical ventilation should be used as soon as possible if non-invasive mechanical ventilation can not alleviate the symptoms in patients more than0.5hours.

Key words: heart failure, intubation, intratracheal, noninvasive ventilation, noninvasive mechanical ventilation, acute left cardiac dysfunction, timing