ABSTRACT
Objective To investigate the curative effect of noninvasive mechanical ventilation (NMV) and its influence on plasma brain natriuretic peptide (BNP) and endothelin-1 (ET-1) in senile patients with cot pulmonale complicated with respiratory failure. Methods Eighty senile patients with cot pulmonale complicated with respiratory failure were randomly divided into treatment group (40 cases) and control group (40 cases). The treatment group was treated by NMV combined with routine therapy, and the control group was treated by only routine therapy including respiratory stimulant,lowering pulmonary artery pressure, cardiotonic agents, diuretics and nasal catheter oxygen inhalation. Blood pressure, heart rate (HR), respiratory rate (RR), blood gas analysis (pH, PaO2, PaCO2 ,SaO2) and clinical symptoms and signs were observed before and 72 hours after treatment. The plasma levels of BNP and ET-1 were also measured before and after treatment. Results Compared with the control group, the clinical symptoms and signs were significantly improved, SaO2 and PaO2 were significantly elevated, and PaCO2, HR and RR were significantly reduced in NMV group (t=2.23 ～ 3.92, P< 0.05 or P< 0.01). The plasma levels of BNP and ET-1 were significantly decreased after treatment in both groups,especially in the treatment group (t=2. 93,3. 56, P<0.01). The plasma levels of BNP and ET-1 had significantly negative correlation with PaO2 (r=-0.69,-0.61 ,P<0. 01) ,and positive correlation with PaCO2 (r= 0.51,0.42, P<0. 05). Conclusions NMV can improve hypoxemia and CO2 retention in senile patients with cot pulmonale complicated with respiratory failure,and may have some influences on neuroendocrine functions.