Abstract:

To improve the status of management in respiratory failure in China, the project of Studies on Pathogenesis and Treatment of Respiratory Failure was designed and conducted by three medical centers(Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Affiliate of Capital Medical University; Zhongshan HospitalFudan University; and Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical College) for more than ten years. This project focused on pathogenesis and treatment strategies of respiratory failure and achieved the following important innovations: (1) Pulmonary Infection Control Window(PIC Window) was firstly proposed and be used to determine the time switching point of sequential invasive-noninvasive ventilation; (2) The largest sample size of early use of noninvasive positive pressure ventilation(NPPV) for acute exacerbated COPD(AECOPD) on general ward provided the evidence-based data for expanding the indication of NPPV from treating respiratory failure to alleviating respiratory muscle fatigue; (3)Three new type masks with intellectual property for NPPV were developed; (4) By designing intrinsic expiratory end positive pressure(PEEPi) lung model with property of expiratory flow limitation, PEEPi was confirmed to be the most important factor to increase inspiratory difficulty; (5) The systematic measuring method of the diaphragm strength and endurance was established; (6) We firstly confirmed that aquaporin 1 (AQP1) was the key channel of fluid transportation in the lung; (7) A multicenter prospective cohort study provided objective data that depression has causal effect on COPD exacerbations and hospitalization; (8) The two guidelines for NPPV and mechanical ventilation of AECOPD were initiated by this group. This project has been acquired widespread use in clinical practice and promoted the research and treatment of respiratory failure in China.

Key words: respiratory failure, artificial ventilation, noninvasive positive pressure ventilation, aquaporin, pulmonary disease, obstructive, lung injury