关键词: 慢性阻塞性肺疾病, 无创通气, 抽吸, 经皮血气监测, ROX指数, VOX指数

Abstract: Objective To establish the relationship between the Oxygenation dropped dramatically after suction and respiratory effort index(ROX index and VOX index) in patients with acute exacerbation of chronic obstructive pulmonary disease treated with non-invasive positive pressure ventilation(NIPPV), and the predictive value of respiratory effort index on the time of suction. Methods This is a single-center descriptive study, to investigate 140 AECOPD patients with NIPPV treated in the emergency intensive care unit of a 3A Grade Hospital in Qingdao from October 2022 to November 2023, the ROX index and VOX index were monitored and calculated within 24h of non-invasive positive pressure ventilation and during sputum aspiration, the frequency and duration of a dramatic drop in SPO2(> 10%) after sputum aspiration were assessed. To analyze the correlation between ROX Index, VOX index and SPO2 sharp drop after sputum aspiration, and determine the critical value of ROX Index, VOX index to predict SPO2 sharp drop after sputum aspiration. Results SPO2 decreased dramatically after sputum aspiration (> 10%) in 98 patients (70.0%), with duration of 16 s-30 s and > 30 s accounting for 53.6% and 7.1% , respectively. The results of correlation analysis showed that VOX index was positively correlated with the frequency and duration of SPO2 decrease after sputum aspiration (p < 0.05) , ROX index was negatively correlated with the frequency and duration of SPO2 decrease after sputum aspiration (p < 0.05) . The area under the ROC curve of the baseline VOX index was 0.970. 95% CI: 0.939-0.967) . The area under the ROC curve of the VOX index 1 hour before sputum aspiration was 0.893(95% CI: 0.826-0.959) . Conclusion When VOX index ≥0.0074 after 1 h of NIPPV and VOX index ≥0.0087 within 1 h before sputum aspiration, we should be alert to the occurrence of dramatic SPO2 reduction after sputum aspiration.

Key words: Chronic obstructive pulmonary disease, Noninvasive ventilation, Suction, Transcutaneous blood gas monitoring, ROX Index, VOX index