有创机械通气在重度高碳酸血症性昏迷患者中的应用时机与疗效观察

Objective To explore the application timing and therapeutic effect of invasive mechanical ventilation in patients with severe hypercapnia-induced coma. Methods On January 4, 2026, a patient with chronic obstructive pulmonary disease complicated with acute lower respiratory tract infection and severe hypercapnia with type II respiratory failure was admitted to the hospital. Due to the failure of non-invasive respiratory assistance in improving blood oxygen saturation, the patient's blood pressure gradually decreased, and the bedside partial pressure of carbon dioxide continued to rise, invasive mechanical ventilation was given. On February 23, 2022, a patient with chronic obstructive pulmonary disease and type II respiratory failure was admitted and given intubation mechanical ventilation. Results After receiving invasive mechanical ventilation, the patient 1's bedside pH value improved from 7.201↓ to 7.512↑, bedside partial pressure of oxygen improved from 22 mmHg↓ to 152 mmHg↑, bedside partial pressure of carbon dioxide improved from 92.9 mmHg↑ to 27.4 mmHg↓, and bedside oxygen saturation improved to 100%↑. After invasive mechanical ventilation and related treatments, patient 2's condition improved, body temperature: 36.5℃, heart rate: 117 beats/min, respiratory rate: 23 breaths/min, blood pressure: 134/95 mmHg(maintained with dopamine for blood pressure elevation), oxygen saturation: 100%, and the patient was discharged after recovery. Conclusion For patients with hypercapnia that cannot be relieved by non-invasive ventilation, timely and reasonable use of invasive mechanical ventilation can be considered, which is helpful in alleviating the patient's condition.