The Mechanism of Acetylcysteine Aerosol Inhalation Combined with Non-invasive Ventilator NIPSV Mode in the Treatment of AECOPD with Respiratory Failure by Regulating Immune Inflammatory Response

Weihua ZHANG; Shanshan QIN; Sicong WEN; Pingyu WU; Zhaoguang SONG

doi:10.12259/j.issn.2095-610X.S20240717

Volume 45 Issue 7

Jul. 2024

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2024 > 45(7): 113-118

Weihua ZHANG, Shanshan QIN, Sicong WEN, Pingyu WU, Zhaoguang SONG. The Mechanism of Acetylcysteine Aerosol Inhalation Combined with Non-invasive Ventilator NIPSV Mode in the Treatment of AECOPD with Respiratory Failure by Regulating Immune Inflammatory Response[J]. Journal of Kunming Medical University, 2024, 45(7): 113-118. doi: 10.12259/j.issn.2095-610X.S20240717

Citation:

Weihua ZHANG, Shanshan QIN, Sicong WEN, Pingyu WU, Zhaoguang SONG. The Mechanism of Acetylcysteine Aerosol Inhalation Combined with Non-invasive Ventilator NIPSV Mode in the Treatment of AECOPD with Respiratory Failure by Regulating Immune Inflammatory Response[J]. Journal of Kunming Medical University, 2024, 45(7): 113-118. doi: 10.12259/j.issn.2095-610X.S20240717

Citation:

Weihua ZHANG, Shanshan QIN, Sicong WEN, Pingyu WU, Zhaoguang SONG. The Mechanism of Acetylcysteine Aerosol Inhalation Combined with Non-invasive Ventilator NIPSV Mode in the Treatment of AECOPD with Respiratory Failure by Regulating Immune Inflammatory Response[J]. Journal of Kunming Medical University, 2024, 45(7): 113-118. doi: 10.12259/j.issn.2095-610X.S20240717

PDF( 588 KB)

The Mechanism of Acetylcysteine Aerosol Inhalation Combined with Non-invasive Ventilator NIPSV Mode in the Treatment of AECOPD with Respiratory Failure by Regulating Immune Inflammatory Response

doi: 10.12259/j.issn.2095-610X.S20240717

Dept. of Critical Care Medicine，Tongcheng People’s Hospital of Anhui Province，Tongcheng Anhui 231400，China

Received Date: 2024-02-26
Available Online: 2024-06-14
Publish Date: 2024-07-25

Abstract

Abstract

Objective To explore the mechanism of acetylcysteine aerosol inhalation combined with non-invasive ventilator pressure supported ventilation （NIPSV） in the treatment of acute stage of chronic obstructive pulmonary disease （AECOPD） complicated with respiratory failure by regulating the immune inflammatory response. Methods A total of 80 patients with AECOPD combined with respiratory failure who were treated in Tongcheng People's Hospital of Anhui Province from February 2020 to December 2022 were selected and divided into experimental group （n = 42） and control group （n = 38） according to different treatment plans. The experimental group was treated with NIPSV mode combined with acetyl cysteine atomization inhalation. The control group was treated with non-invasive ventilator NIPSV mode. The pulmonary function of the two groups before and after treatment was compared, including forced expiratory volume （FEV1）, forced vital capacity （FVC） and FEV1/FVC. Blood gas index: arterial partial pressure of oxygen （PaO₂）, arterial carbon dioxide （PaCO₂）, and blood oxygen saturation （SaO₂）; Serum indicators: Interleukin-6 （IL-6）, amyloid A （SAA）, C-reactive protein （CRP）, T lymphocyte subsets （CD3⁺, CD4⁺, CD8⁺） levels, and the incidence of adverse reactions during treatment were compared. Results After treatment, the levels of FEV1, FVC and FEV1/FVC in experimental group were significantly higher than those in control group and before treatment （P < 0.05）. After treatment, PaO₂, PaCO₂ and SaO₂ levels in the experimental group were higher than those in the control group and before treatment （P < 0.05）. The levels of IL-6, SAA and CRP in the experimental group after treatment were lower than those in the control group and before treatment （P < 0.05）. After treatment, the levels of CD3⁺ and CD4⁺ were increased in both groups, the experimental group was higher than the control group, the CD8⁺ level was lower in the experimental group than the control group （P < 0.05）. The incidence of adverse reactions in experimental group was significantly lower than that in control group （P < 0.05）. Conclusion AECOPD combined with non-invasive ventilator NIPSV and acetylcysteine inhalation can effectively reduce the inflammatory response, improve lung function and immune function, and improve blood gas indexes in patients with respiratory failure.

FullText(HTML)

References(21)

References

[1]	Wang S M,Zhang F Y,Du C L,et al. Epidemiology and issues of NIV-treated AECOPD patients with hypercapnic respiratory failure in Shanghai: A multicentre retrospective survey[J]. Clin Respir J,2021,15(5):550-557. doi: 10.1111/crj.13311
[2]	Zhang J B,Zhu J Q,Cao L X,et al. Use of the modified glasgow coma scale score to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with AECOPD and respiratory failure[J]. Exp Ther Med,2020,20(2):1441-1446. doi: 10.3892/etm.2020.8884
[3]	Feng Z, Zhang L, Yu H, et al. High-flow nasal cannula oxygen therapy versus non-invasive ventilation for AECOPD patients after extubation: A systematic review and meta-analysis of randomized controlled trials[J]. Int J Chron Obstruct Pulmon Dis, 2022, 17（1）: 1987-1999. Feng Z,Zhang L,Yu H,et al. High-flow nasal cannula oxygen therapy versus non-invasive ventilation for AECOPD patients after extubation: A systematic review and meta-analysis of randomized controlled trials[J]. Int J Chron Obstruct Pulmon Dis,2022,17(1): 1987-1999.
[4]	McGinn K A,Weigartz K,Lintner A,et al. Nebulized heparin with N-acetylcysteine and albuterol reduces duration of mechanical ventilation in patients with inhalation injury[J]. J Pharm Pract.,2019,32(2):163-166. doi: 10.1177/0897190017747143
[5]	张弘,蔡柏蔷. 2017 ERS/ATS慢性阻塞性肺疾病急性加重管理指南解读[J]. 国际呼吸杂志,2017,37(9):641-646. doi: 10.3760/cma.j.issn.1673-436X.2017.09.001
[6]	Cortegiani A,Longhini F,Madotto F,et al. High flow nasal therapy versus noninvasive ventilation as initial ventilatory strategy in COPD exacerbation: A multicenter non-inferiority randomized trial[J]. Crit Care,2020,24(1):692. doi: 10.1186/s13054-020-03409-0
[7]	Gao E,Zhang C,Wang J. Effects of budesonide combined with noninvasive ventilation on PCT,sTREM-1,chest lung compliance,humoral immune function and quality of life in patients with AECOPD complicated with type II respiratory failure[J]. Open Med (Wars),2019,14(1):271-278. doi: 10.1515/med-2019-0023
[8]	Zhang X,Yang P,Guo C,et al. Effects of volume-assured pressure support noninvasive ventilation in stable COPD with chronic respiratory failure: Meta-analysis and literature review[J]. Heart Lung,2020,49(3):287-295. doi: 10.1016/j.hrtlng.2020.01.007
[9]	Ghazala L,Hatipoğlu U,Devnani T,et al. Duration of noninvasive ventilation is not a predictor of clinical outcomes in patients with acute exacerbation of COPD and respiratory failure[J]. Can J Respir Ther,2021,57(1):113-118.
[10]	Van Der Leest S,Duiverman ML. High-intensity non-invasive ventilation in stable hypercapnic COPD: Evidence of efficacy and practical advice[J]. Respirology,2019,24(4):318-328. doi: 10.1111/resp.13450
[11]	杨宝春,王丽东,孙欣. 乙酰半胱氨酸胶囊联合双水平无创正压通气治疗AECOPD合并Ⅱ型呼吸衰竭观察[J]. 中国药师,2020,23(3):485-487. doi: 10.3969/j.issn.1008-049X.2020.03.018
[12]	李春梅,胡莺,陈晓霞,等. 无创正压通气联合纤维支气管镜肺泡灌洗对老年AECOPD合并Ⅱ型呼吸衰竭患者肺功能及血气指标的影响[J]. 现代生物医学进展,2019,19(24):4752-4755.
[13]	刘小珊,谢芳,郝小丹,等. 肠内-肠外联合营养与双水平气道正压通气对COPD急性加重期合并Ⅱ型呼吸衰竭患者的应用效果[J]. 贵州医科大学学报,2023,48(3):347-351,372.
[14]	Abubacker A P,Ndakotsu A,Chawla H V,et al. Non-invasive positive pressure ventilation for acute cardiogenic pulmonary edema and chronic obstructive pulmonary disease in prehospital and emergency settings[J]. Cureus,2021,13(6):e15624.
[15]	Sun J,Li Y,Ling B,et al. High flow nasal cannula oxygen therapy versus non-invasive ventilation for chronic obstructive pulmonary disease with acute-moderate hypercapnic respiratory failure: An observational cohort study [published correction appears in Int J Chron Obstruct Pulmon[J]. Int J Chron Obstruct Pulmon Dis,2019,14(1):1229-1237.
[16]	王宁,杨佳佳,王丹丹,等. 慢性阻塞性肺疾病急性加重合并呼吸机相关性肺炎患者病原菌分布及血清指标水平变化[J]. 实用医院临床杂志,2022,19(2):50-53. doi: 10.3969/j.issn.1672-6170.2022.02.014
[17]	裴蕾,李黎. 血清SP-D、SAA和CXCL12在AECOPD合并呼吸衰竭预后评估中的临床价值[J]. 检验医学与临床,2021,18(9):1270-1273,1277. doi: 10.3969/j.issn.1672-9455.2021.09.023
[18]	李中祎,张治,曹路,等. N-乙酰半胱氨酸联合无创正压通气治疗COPD急性发作的临床分析[J]. 中华肺部疾病杂志(电子版),2020,13(2):188-192. doi: 10.3877/cma.j.issn.1674-6902.2020.02.012
[19]	张媛媛,宫硕康,张新,等. 呼吸康复治疗联合乙酰半胱氨酸治疗COPD急性加重期的临床观察[J]. 川北医学院学报,2022,37(1):63-66. doi: 10.3969/j.issn.1005-3697.2022.01.015
[20]	李静,覃腊云,欧阳辉,等. 序贯肠内外营养支持对AECOPD合并呼吸衰竭患者营养指标、胃肠黏膜功能和免疫功能的影响[J]. 现代生物医学进展,2022,22(7):1333-1337.
[21]	付伟,辛丽云,陈乾华. 乙酰半胱氨酸溶液雾化吸入对COPD患者免疫功能及肺功能的影响[J]. 实用药物与临床,2019,22(6):597-600.

Relative Articles(20)

Relative Articles

[1]	Ji WANG, Songtao BIN, Li TAN. Study on the Efficacy of Acetylcysteine in Severe Pneumonia in Children under Electronic Bronchoscopy. Journal of Kunming Medical University, 2024, 45(6): 113-119. doi: 10.12259/j.issn.2095-610X.S20240615
[2]	Zeng Xiao Ying , Zhang Chuan , Le Tao , Jiang Li Dong , Wang Xi , Ye Dan , Ke Li , Zhang Yi . . Journal of Kunming Medical University, 2019, 40(12): 80-85.
[3]	An Chun Xia , Tao Guang Hua , Ze Xue Ying . . Journal of Kunming Medical University, 2019, 40(06): 114-120.
[4]	Niu Yan , Zhang Yue , Bai Zhong , Yang Xiao Hong , Wu Hai Ying , Cao Shou Ming , Ma Yan , Lv Cao . The Application of 256-Slice Spiral CT in the Diagnosis of Obstructive Sleep Apnea Hypopnea Syndrome. Journal of Kunming Medical University, 2018, 39(08): 55-58.
[5]	Huang Li , Huang Xian Xiang . A Study of the Level Expression and Clinical Efficacy of Noninvasive Mechanical Ventilation in the Treatment of Insulin-like Growth Factor Ⅰ, Ⅱ and Cathepsin B in Patients with Chronic Obstructive Pulmonary Disease. Journal of Kunming Medical University, 2018, 39(08): 74-79.
[6]	Jiang Ping Fei , Hu Qiang . An Observation on the Change of Hemodynamic and Respiratory Mechanical Parameters of Patients with Respiratory Failure. Journal of Kunming Medical University, 2018, 39(08): 51-54.
[7]	Zhang Le , Xia Jia Wei , Chen Hai Yun , Huang Ying . . Journal of Kunming Medical University, 2018, 39(11): 93-97.
[8]	Du Ru Fei , Ding Wei Xing , Liu Yun Song , Zhang Can Hua . . Journal of Kunming Medical University, 2017, 38(05): 125-128.
[9]	Li Ya Ping , Li Yong Xia , Niu Xiao Qun , Hai Bing , Cao Yu , Chai Yan Ling . Correlation between Smoking and Inflammatory Factors in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Complicated with Pulmonary Hypertension. Journal of Kunming Medical University, 2017, 38(06): 92-96.
[10]	Liu Jian Hong , Zhou Ji Bo . . Journal of Kunming Medical University, 2017, 38(03): 39-42.
[11]	Yang Huan Zhi . . Journal of Kunming Medical University,
[12]	Liu Rong . . Journal of Kunming Medical University,
[13]	Shen Yue Ling . . Journal of Kunming Medical University,
[14]	Yang Xiao Ling . . Journal of Kunming Medical University,
[15]	Tao Hong Fei . . Journal of Kunming Medical University,
[16]	Wang Chang Jie . . Journal of Kunming Medical University,
[17]	Sun Mei Hong . . Journal of Kunming Medical University,
[18]	Chai Yan Ling . The Clinical Effect of YADRAN Tooth Powder Combined with Periodental Non-surgical Treatment on Periodontitis. Journal of Kunming Medical University,
[19]	. Association between Serum Homocyteine and Coronary Arteriosclerosis. Journal of Kunming Medical University,
[20]	. Clinical Evaluation of the Treatment of Acute Type Ⅰ Respiratory Insufficiency with Continuous Positive Airway Pressure Delivered by Face Mask in Elderly Patients. Journal of Kunming Medical University,