Influencing Factors for Duration of Mechanical Ventilation in Patients with Type II Respiratory Failure Due to Chronic Obstructive Pulmonary Disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 NIU Zhiwei , SUN Haifeng , CHEN Xisheng

Department of Respiratory Medicine, Beijing Shunyi Hospital, China Medical University. Beijing, 101300, China;

Corresponding author：

NIU Zhiwei, Email: niuzw0421@tom.com

Keywords：

Chronic obstructive pulmonary disease; Mechanical ventilation; Respiratory insufficiency; Nutrition disorders; Ventilator weaning

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Objective To study the influencing factors for duration of mechanical ventilation in chronic obstructive pulmonary disease ( COPD) patients with type II respiratory failure. Methods Twenty-eight cases of mechanical ventilated COPD patients with type II respiratory failure were enrolled from March 2006 to March 2008 in Beijing Shunyi Hospital. They were divided into two groups based on their duration of ventilation: ≤7 d group as group I, and gt; 7 d as group II. Data of heart rate and blood pressure were recorded before the trachea intubation. Clinical data of blood routine, blood gas analysis and serum biochemistry were collected and analyzed. Previous history, smoking history and subsequent complications were also recorded. Results Heart rate in the group II were significantly higher than which in the group I[ ( 121. 50 ±17. 20) /min vs ( 103. 08 ±19. 97) /min, P lt;0. 05] . The incidences of upper gastrointestinal hemorrhage and blood pressure fall immediately after intubation were 63% and 88% respectively in the group II, which were significantly higher than the group I ( 0 and 25% ) . The levels of albumin, pre-albumin, Na+ , PaO2 were ( 29. 06 ±5. 00) g /L, ( 66. 36 ±17. 72) mg/L,( 138. 45 ±4. 74) mmol /L and ( 49. 06 ±20. 11) mm Hg respectively in the group II. While in the group I, those were ( 37. 11 ±2. 73) g /L, ( 127. 70 ±35. 84) mg/L, ( 143. 29 ±3. 42) mmol /L and ( 72. 25 ±38. 69) mm Hg respectively, which showed significant differences compared with the grouop II. The incidence of previous concomitant cerebral infarction showed significant difference between the group I and group II( 33. 33% vs 0) .Conclusion The levels of albumin, pre-albumin, heart rate before the intubation, upper gastrointestinal hemorrhage and blood pressure fall immediately after the intubation are associated with duration of mechanical ventilation and may indicate the prognosis in COPD patients with type II respiratory failure.

Citation： NIU Zhiwei,SUN Haifeng,CHEN Xisheng. Influencing Factors for Duration of Mechanical Ventilation in Patients with Type II Respiratory Failure Due to Chronic Obstructive Pulmonary Disease. Chinese Journal of Respiratory and Critical Care Medicine, 2009, 09(1): 36-39. doi: Copy

1.	朱蕾。有创-无创“序贯”机械通气治疗慢性阻塞性肺疾病呼吸衰竭. 中国呼吸与危重监护杂志, 2003, 2: 198-199.
2.	连宁芳, 朱蕾. 机械通气的并发症. 中国呼吸与危重监护杂志,2004, 3: 144-146.
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5.	Yarkin T, Karakurt Z, B lükba i Y, et al. Evaluation of the weaning process in COPD patients with acute respiratory failure. Tuberk Toraks, 2008, 56: 64-73.
6.	Bouachour G, Guiraud MP, Gouello JP, et al. Gastric intramucosal pH: an indicator of weaning outcome from mechanical ventilation in COPD patients. Eur Respir J, 1996 , 9: 1868-1873.
7.	蔡映云, 主编. 呼吸重症监护和治疗. 北京: 科学技术和文献出版社, 2006, 194-201.
8.	Robriquet L, Georges H, Leroy O, et al. Predictors of extubation failure in patients with chronic obstructive pulmonary disease. J Crit Care, 2006, 21: 190-192.
9.	Nevins ML, Epstein SK. Predictors of outcome for patients with COPD requiring invasive mechanical ventilation. Chest, 2001, 119 :1840-1849.
10.	Chandra D, Guntupalli KK, Guleria R. Hypotension is a predictor of mortality in acute exacerbations of chronic obstructive pulmonary disease. Indian J Chest Dis Allied Sci, 2007, 49: 13-18.

1. 朱蕾。有创-无创“序贯”机械通气治疗慢性阻塞性肺疾病呼吸衰竭. 中国呼吸与危重监护杂志, 2003, 2: 198-199.
2. 连宁芳, 朱蕾. 机械通气的并发症. 中国呼吸与危重监护杂志,2004, 3: 144-146.
3. Delmore BA. Levine ’s framework in long-term ventilated patients during the weaning course. Nurs Sci Q, 2006, 19: 247-258.
4. Lo HC, Lin CH, Tsai LJ. Effects of hypercaloric feeding on nutrition status and carbon dioxide production in patients with long-term mechanical ventilation. J Parenter Enteral Nutr, 2005 , 29: 380 -387.
5. Yarkin T, Karakurt Z, B lükba i Y, et al. Evaluation of the weaning process in COPD patients with acute respiratory failure. Tuberk Toraks, 2008, 56: 64-73.
6. Bouachour G, Guiraud MP, Gouello JP, et al. Gastric intramucosal pH: an indicator of weaning outcome from mechanical ventilation in COPD patients. Eur Respir J, 1996 , 9: 1868-1873.
7. 蔡映云, 主编. 呼吸重症监护和治疗. 北京: 科学技术和文献出版社, 2006, 194-201.
8. Robriquet L, Georges H, Leroy O, et al. Predictors of extubation failure in patients with chronic obstructive pulmonary disease. J Crit Care, 2006, 21: 190-192.
9. Nevins ML, Epstein SK. Predictors of outcome for patients with COPD requiring invasive mechanical ventilation. Chest, 2001, 119 :1840-1849.
10. Chandra D, Guntupalli KK, Guleria R. Hypotension is a predictor of mortality in acute exacerbations of chronic obstructive pulmonary disease. Indian J Chest Dis Allied Sci, 2007, 49: 13-18.

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Influencing Factors for Duration of Mechanical Ventilation in Patients with Type II Respiratory Failure Due to Chronic Obstructive Pulmonary Disease

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