scholarly journals Effect of different modes of mechanical ventilation on chronic obstructive pulmonary disease patients with respiratory failure regarding echocardiographic changes and diaphragmatic ultrasound

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
enas mahdy ◽  
Ahmed Gouda Mohamed Elgazzzar ◽  
Bsem Aglan ◽  
tarek essawy ◽  
Emad rezk
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals Apnea-Hypopnea Index in Chronic Obstructive Pulmonary Disease Exacerbation Requiring Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Killen H. Briones-Claudett ◽  
Adela Romero Lopez ◽  
Mónica H. Briones-Claudett ◽  
Mariuxi del Pilar Cabrera Baños ◽  
Killen H. Briones Zamora ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Pulmonary Disease ◽  
Apnea Hypopnea Index ◽  
Chronic Obstructive ◽  
Disease Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Hypercapnic Respiratory Failure ◽  
Acute Hypercapnic Respiratory Failure

Introduction. This study intends to determine the Apnea-Hypopnea Index in patients hospitalized with acute hypercapnic respiratory failure from chronic obstructive pulmonary disease exacerbation, who require noninvasive ventilation with average volume-assured pressure support (AVAPS), as well as describes the clinical characteristics of these patients. Materials and Methods. We designed a single-center prospective study. The coexistence of Apnea-Hypopnea Index and clinical, gasometric, spirometric, respiratory polygraphy, and ventilatory characteristics were determined. The clinical characteristics found were categorized and compared according to the Apnea-Hypopnea Index (AHI) < 5, AHI 5–15, and AHI >15. A p value <0.05 was considered statistically significant. Results. During the study period, a total of 100 patients were admitted to the ICU with a diagnosis of acute hypercapnic respiratory failure due to COPD exacerbation. 72 patients presented with acute respiratory failure and fulfilled criteria for ventilatory support. Within them, 24 received invasive mechanical ventilation and 48 NIV. After applying the inclusion criteria for this study, 30 patients were eligible. An AHI >5 was present in 24 of the 30 patients recruited (80%). Neck circumference (cm), Epworth scale, and Mallampati score evidenced significant differences when compared to the patient’s AHI <5, AHI 5–15, and AHI >15 ( p < 0.05 ). Furthermore, patients with an AHI >5 had longer hospital admissions, prolonged periods on mechanical ventilation, and a higher percentage of intubation rates. Conclusion. Apnea-Hypopnea Index and chronic obstructive pulmonary disease exacerbation are a frequent association found in patients with acute hypercapnic respiratory failure and COPD exacerbations that require NIV. This association could be a determining factor in the response to NIV, especially when AVAPS is used as a ventilatory strategy.

Comparison between different weaning methods in chronic obstructive pulmonary disease patients with respiratory failure (BIPAP, CPAP and T piece)

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Omar Mohamed Taha Elsafty ◽  
Osama Ramzy Yousef ◽  
Marwa Mostafa Mohamed Mowafy ◽  
Ahmed Farag Abdelsamie Sadek Salama
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Gas Exchange ◽  
General Hospital ◽  
Pulmonary Disease ◽  
Invasive Mechanical Ventilation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Icu Stay

Abstract Background Invasive mechanical ventilation (IMV) for management of chronic obstructive pulmonary disease (COPD) associated respiratory failure is increasing in Intensive Care Units. The bridging process from IMV to extubation is called weaning in which mechanical ventilation is gradually withdrawn and the patient resumes spontaneous breathing. Many objective parameters have been defined for weaning success. The following review focuses on the different weaning methods in patients chronic obstructive pulmonary disease with respiratory failure. Objective To compare among the different methods of weaning in chronic obstructive pulmonary disease patients with respiratory failure weaned with different method ie BIPAP, CPAP and T-Piece. Patients and Methods Cross sectional descriptive study. 60 patients diagnosed as COPD with respiratory failure on MV, will be recruited from ICU Department Zefta general hospital. This study included 60 patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) with age more than18 years old admitted in adult ICU Department in Zefta general hospital that are on mechanical ventilation. These patients fulfilled the inclusion criteria of the study. Patients were classified randomly into 3 groups. Results In this study I try to overcome these challenges by studying the effect of using of NIPPV both CPAP or BIPAP immediately after extubation or using T piece for 1 hour followed by extubation and using oxygen therapy that BIPAP improves patient gas exchange, hemodynamics and associated with shortest ICU stay which reflects on utilization of resources. Conclusion We suggest that BIPAP improves patient gas exchange specially in hypercapnic patients, hemodynamics and associated with shortest duration of ICU stay and decrease rate of reintuabtion.

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