The Journal of Practical Medicine >
Evaluation of the effect of three nebulizing inhalation methods on patients with acute exacerbation of chronic obstructive pulmonary disease treated by non⁃invasive ventilation
Received date: 2025-03-21
Online published: 2025-06-19
Objective To compare the effects of non-invasive intermittent oxygen-driven nebulization, non-invasive intermittent air-driven nebulization, and non-invasive simultaneous air-driven nebulization on the dynamic changes of partial pressure of carbon dioxide (PtCO2), pulse oxygen saturation (SpO2), and heart rate during nebulization, as well as the therapeutic effects in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods A total of 99 patients with acute exacerbation of COPD requiring non-invasive mechanical ventilation and nebulization were randomly divided into a control group, an experimental group one, and an experimental group two, with 33 patients in each group. The control group was given non-invasive intermittent oxygen-driven nebulization, the experimental group one was given non-invasive intermittent air-driven nebulization, and the experimental group two was given non-invasive simultaneous air-driven nebulization. The changes in PtCO2, SpO2, and heart rate at 0 min, 5 min, 10 min, 15 min during nebulization, 5 min, 10 min, and 15 min after nebulization were recorded. The values of arterial blood gas PaCO2 and PaO2 were recorded every morning from before treatment to the 7th day of treatment. The length of hospital stay in the three groups was also recorded. Results The comparison of PtCO2 during nebulization among the three groups showed that there were statistically significant differences in the main effect of time and the interaction effect of time and group (P < 0.001). The PtCO2 values in the control group showed a linear relationship with time (F = 10.166, P = 0.003), increasing over time; the PtCO2 values in the experimental group one showed a linear relationship with time (F =10.544, P = 0.003), decreasing over time; the PtCO2 values in the experimental group two showed a linear relationship with time (F = 20.003, P < 0.001), decreasing over time. A one-way ANOVA was conducted on the PtCO2 values at each time point in the three groups. The PtCO2 value at 15 min of nebulization in the control group was higher than that in the experimental group one and the experimental group two. There were statistically significant differences in the difference in PtCO2 before and after nebulization (dPtCO2) between the experimental group one and the experimental group two and the control group (P<0.05). A one-way ANOVA was conducted on the PtCO2 values at each time point during the observation period after nebulization. The results showed that there were statistically significant differences in PtCO2 at 0 min and 5 min after nebulization among the three groups (P < 0.05), while there were no statistically significant differences in PtCO2 at 10 min and 15 min after nebulization among the three groups (P > 0.05). The comparison of SPO2 during nebulization among the three groups showed that there were statistically significant differences in the interaction effect of time and group (P < 0.05). The SPO2 values in the experimental group one decreased over time. The SPO2 values at 10 min and 15 min of nebulization in the control group were higher than those in the experimental group one and the experimental group two. All three groups could improve PaCO2 in arterial blood gas with the treatment days (P<0.05). Conclusions All three nebulization treatment methods can achieve good therapeutic effects. However, non-invasive intermittent oxygen-driven nebulization can increase PtCO2 and SPO2 during nebulization; non-invasive intermittent air-driven nebulization can decrease PtCO2 and SPO2 during nebulization; non-invasive simultaneous air-driven nebulization can decrease PtCO2 and maintain stable SPO2 during nebulization. Therefore, non-invasive simultaneous air-driven nebulization is a relatively safer nebulization inhalation method and is worthy of clinical promotion.
Yan YANG , Li YAO , Wenxia WAN , Zhenzhen ZHOU , Nan LING . Evaluation of the effect of three nebulizing inhalation methods on patients with acute exacerbation of chronic obstructive pulmonary disease treated by non⁃invasive ventilation[J]. The Journal of Practical Medicine, 2025 , 41(11) : 1694 -1704 . DOI: 10.3969/j.issn.1006-5725.2025.11.013
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