Effectiveness of taking sequential mechanical ventilation in AECOPD with respiratory failure and risk factors for treatment failure

Background To analyze the effect of sequential mechanical ventilation and the risk factors of treatment failure in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with expiratory failure. Methods This study retrospectively analyzed the clinical data of 125 patients with AECOPD and respiratory failure admitted to the Respiratory and Critical Care Medicine Department of the Central Theater Command General Hospital from January 2021 to December 2023 and observed the changes in arterial partial pressure of oxygen (PaO 2 ), partial pressure of carbon dioxide (PaCO 2 ), and heart rate (HR), respiration (RR), spirometry (FVC), as well as the changes in peak expiratory flow rate (PEF) before and after treatment. As well as the differences in the indexes of the first exertion expiratory volume (FEV1). Combined with the treatment outcome was divided into the treatment failure group the success group, and the logistic regression equation to determine the main factors of the failure of sequential ventilation treatment. Using ROC curve analysis to evaluate the predictive performance of logistic regression models, calculate the area under the curve (AUC) and its 95% confidence interval (CI). Results PaO 2 , FVC, PEF, and FEV1 levels of the patients after treatment were increased compared with those before treatment, and the levels of PaCO 2 , HR, and RR were decreased ( p < 0.05). Thirty cases were included in the failure group, and the remaining 95 cases were included in the success group. There were statistical differences in age, presence of medical diseases, acute physiology and chronic health evaluation II (APACHE II) score, PaO 2 , and PaCO 2 levels between the two groups ( p < 0.05). The ROC curve showed good discriminative ability, with an AUC of 0.864 (95% CI: 0.803–0.925, p < 0.05). Conclusion Sequential ventilation therapy can improve blood gas indexes and lung function and stabilize vital signs in patients with AECOPD with expiratory failure. Moreover, age ≥60 years, presence of medical diseases, APACHE II score ≥19, PaO 2 <55 mmHg, and PaCO 2 ≥75 mmHg are risk factors for treatment failure.