ORIGINAL ARTICLE
Year : 2015  |  Volume : 9  |  Issue : 2  |  Page : 125-132

The impact of pulmonary functions on outcome of intubated patients with chronic obstructive pulmonary disease


1 Department of Chest, Faculty of Medicine, Assuit University, Assuit, Egypt
2 Department of Clinical Pathology, Faculty of Medicine, Assuit University, Assuit, Egypt

Correspondence Address:
Khaled Hussein
Chest Department, Assiut University Hospital, Assuit 71111
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1687-8426.158041

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Background: Assessment of lung mechanics and respiratory muscle determinants is considered to be useful for adjustment of ventilator settings to minimize dynamic hyperinflation in patients with chronic obstructive pulmonary disease (COPD). Objective: The aim of this study is to assess the impact of pulmonary functions on the outcome of mechanically ventilated COPD patients. Patients and methods: This study was carried out in the respiratory ICU, chest department, Assiut University Hospital. A total of 47 mechanically ventilated COPD patients were recruited into the study. The patients were divided into two groups on the basis of outcomes: successful group (36 patients) and failed group (11 patients). Analyses of different lung mechanics and respiratory muscle determinants were carried out for both groups. Results: There was no significant difference in age between both the groups. Arterial blood gases analysis showed a significantly decreased pH, PaO 2 , and SaO 2 in the failed group and a significantly increased PaCO 2 in the failed group after 1, 24, and 48 h of mechanical ventilation. Values of lung mechanics in the failed group, compared with the successful group, showed a significantly lower respiratory compliance (29.18 ± 1.47 vs. 45.92 ± 4.08 ml/cm H 2 O), a significantly higher respiratory resistance (24.73 ± 1.19 vs. 22.39 ± 1.10 cm H 2 O/L/S), and a significantly higher intrinsic positive end expiratory pressure (8.36 ± 0.67 vs. 7.58 ± 0.94 cm H 2 O). Values of respiratory muscle determinants in the failed group showed a significantly lower negative inspiratory force (−17.18 ± 2.82 vs. −26.44 ± 3.32 cm H 2 O), a significantly lower vital capacity (382.27 ± 102.75 vs. 810.00 ± 133.03 ml), and a significantly higher occlusion pressure P0.1 (6.09 ± 1.04 vs. 1.72 ± 0.66 cm H 2 O). Conclusion: Pulmonary functions in mechanically ventilated COPD patients including lung mechanics and respiratory muscle determinants had an important impact on outcome. A significant decrease in respiratory compliance, negative inspiratory force, and vital capacity with a significant increase in respiratory resistance, intrinsic positive end expiratory pressure, and occlusion pressure P0.1 was observed in the COPD group with failed extubation.


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