关键词: 肺疾病, 慢性阻塞性；心力衰竭；通气机撤除法

Abstract: ObjectiveTo  investigate the different methods of withdrawing mechanical ventilation in acute exacerbation of chronic obstructive pulmonary disease（AECOPD）with type Ⅱ respiratory failure and acute heart failure (HF). Methods A  prospective，randomized，doubleblinded tudy was performed  in 42 AECOPD patients with type Ⅱ respiratory failure and HF suffering from mechanical ventilation，and the patients were randomly divided into two groups， including  20 cases in study   group A and 22 cases in study group B.The patients  in study group A got   early extubation and sequential noninvasive mechanical ventilation switched by pulmonary infection control window(PIC window)，while those in study group B after spontaneous breathing trial(SBT) had  immediate extubation and  received sequential noninvasive mechanical ventilation. The duration of invasive mechanical ventilation，48 hourintubation rate，the duration of ICU stay，the total duration of ventilatory，inhospital mortality， rate of ventilatorassociated pneumonia(VAP) and the duration of hospital stay were compared between two groups. ResultsThe duration of invasive mechanical ventilation，48 hourintubation rate，the duration of ICU stay，inhospital mortality and rate of ventilatorassociated pneumonia(VAP) were not significantly  different  between two groups（P＞0.05）.The total duration of ventilatory（t=2.135，P=0.039）  and the duration of hospital stay（t=2.098，P=0.042）  were significantly  different between two groups（P＜0.05）.ConclusionThe comparison showed no benefit for PIC window at withdrawing sequential noninvasive and invasive mechanical ventilation with SBT's sequential noninvasive and invasive mechanical ventilation. The total duration of ventilation and the duration of hospital stay in study group A were  longer in study group B.

Key words: pulmonary disease, chronic obstructive, heart , failure, ventilator weaning