Efficacy of nalmefene with noninvasive positive-pressure ventilation on elderly patients with chronic obstructive pulmonary disease combining with type II respiratory failure

Zhen Wu; Heyan Gu; Ronghua Tian; Xia Liu

Efficacy of nalmefene with noninvasive positive-pressure ventilation on elderly patients with chronic obstructive pulmonary disease combining with type II respiratory failure

Am J Transl Res. 2021 Nov 15;13(11):12949-12956. eCollection 2021.

Authors

Zhen Wu¹, Heyan Gu¹, Ronghua Tian¹, Xia Liu¹

Affiliation

¹ Department of Respiratory Medicine, Hai'an City People's Hospital Nantong 226600, Jiangsu Province, China.

PMID: 34956510
PMCID: PMC8661234

Abstract

Objective: To investigate the therapeutic effect of nalmefene combined with noninvasive positive-pressure mechanical ventilation (NIPPV) on elderly patients with chronic obstructive pulmonary disease (COPD) complicated with type II respiratory failure and to explore its influence on TGF-β1/Smads signaling pathway.

Methods: In this retrospective study, data of 106 COPD patients with type II respiratory failure were collected and divided into a research group and a control group based on different treatment, with 53 cases in each group. Both groups were given NIPPV. Besides, the control group was treated with conventional therapy and the research group was treated with nalmefene for 7 days. The changes of heart rate, respiratory rate, clinical efficacy, pulmonary arterial pressure (PAP), serum inflammatory parameters, levels of TGF-β1/Smads signaling pathway related molecules and the incidences of adverse reactions of both groups were compared.

Results: After treatment, the heart rate, respiratory rate, PAP, IL-6 and TNF-α concentrations in both groups were lower than those before treatment (P<0.05). The levels of PaO₂ and SaO₂ were higher and the levels of PaCO₂ were lower than those before treatment in both groups (P<0.05). The expression levels of TGF-β1 and Smad2 in the research group were significantly lower than those in the control group (P<0.05). And all the above indicators in the research group were better than those in the control group after treatment (P<0.05). Besides, the incidence of adverse reactions in the research group was lower than that in the control group (P<0.05).

Conclusion: Nalmefene combined with NIPPV can significantly improve the level of PaO₂ and reduce inflammatory response in elderly COPD patients with type II respiratory failure, and the mechanism may be related to the inhibition of TGF-β1 and Smads expressions.

Keywords: Nalmefene; TGF-β1/Smads; chronic obstructive pulmonary disease; clinical efficacy; positive-pressure ventilation; type II respiratory failure.