Abstract: Objective To analyze and compare the effects of non-invasive patient-ventilator synchrony ventilation (NIV-PSV) and non-invasive neurally adjusted ventilatory assist (NIV-NAVA) on weaning rate and lung function in the patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with respiratory failure in the intensive care unit (ICU). Methods A retrospective analysis was performed on the clinical data of 86 patients with AECOPD and respiratory failure who underwent non-invasive mechanical ventilation intervention in the ICU of our hospital. Among them, 32 patients underwent NIV-NAVA ventilation (NIV-NAVA group), and 54 patients underwent NIV-PSV ventilation (NIV-PSV group). Respiratory mechanics [peak airway pressure (Ppeak), airway platform pressure (Pplat), patient work of breathing (WOBp)], patient-ventilator synchrony (trigger delay time, switching delay time, invalid trigger rate, patient-ventilator asynchrony index) and ventilation efficiency [dead space ventilation rate (VD/VT), functional residual capacity (FRC)] were recorded in the two groups after 1 h of ventilation. The blood gas analysis [arterial partial pressure of blood oxygen (PaO₂), partial pressure of carbon dioxide (PaCO₂)] before ventilation and 1 h after the ventilation,the lung function [forced vital capacity (FVC), peak expiratory flow rate (PEFR)] before ventilation and 7 d after the ventilation were observed and compared, and the success rate of weaning and ICU stay were analyzed in the two groups. Results After 1 h of ventilation, the Ppeak, Pplat, WOBp and trigger delay time, switching delay time, invalid trigger rate, patient-ventilator asynchrony index, VD/VT, and FRC in the NIV-NAVA group were significantly lower than those in the NIV-PSV group (P<0.01). The level of PaO₂ was higher and the level of PaCO₂ was lower in the two groups than those before the ventilation (P<0.05), especially in the NIV-NAVA group (P<0.05). After 7 d of ventilation, the levels of FVC and PEFR in the two groups were significantly higher than those before the ventilation (P<0.05),especially in the NIV-NAVA group (P<0.05). The success rate of weaning in NIV-NAVA group was higher and the intubation rate within 48 h and ICU stay were lower than those in the NIV-PSV group (P<0.05). Conclusions NIV-NAVA ventilation model is superior to NIV-PSV in patient-ventilator synchrony, ventilation efficiency and lung protection. It can successfully wean in the AECOPD patients with respiratory failure and improve the lung function, with significant application value.

Key words: acute exacerbation of chronic obstructive pulmonary disease, respiratory failure, non-invasive patient-ventilator synchrony ventilation, non-invasive neurally adjusted ventilatory assist, dead space ventilation rate