Assessment of Weaning Practice In Mechanically Ventilated Chronic Obstructive Pulmonary Disease Patients at Respiratory Intensive Care Unit of Zagazig University Hospitals

Awad, Mohamed; Shouman, Waheed; Farouk, Mohamed Hassan; Elhawary, Abeer

doi:10.21608/zumj.2019.15367.1377

Assessment of Weaning Practice In Mechanically Ventilated Chronic Obstructive Pulmonary Disease Patients at Respiratory Intensive Care Unit of Zagazig University Hospitals

Document Type : Original Article

Authors

¹ Chest department, faculty of medicine,zagazig university, zagazig, Egypt.

² Chest department, faculty of medicine, zagazig university, zagazig, Egypt.

³ Chest department,faculty of medicin,zagazig university, Zagazig,Egypt

⁴ Chest department, faculty of medicin,zagazig university, zagazig, Egypt

10.21608/zumj.2019.15367.1377

Abstract

Background:Chronic obstructive pulmonary disease is a significant disease which can affect public health and classified as 3rd cause of death ,and described as a preventable and treatable disease associated with air flow limitation which is not completely reversible.40% to 50% of the duration of the mechanical ventilation (MV) support period can be spent in weaning.So the target of this study to evaluate weaning practice in mechanically ventilated patients with COPD disease due to acute exacerbation.
Subjects and Methods: 24 COPD patients admitted to the ICU due to hypercapnic respiratory failure and who required invasive positive pressure mechanical ventilatory support were eligible for enrollment. After the acute phase, all eligible patients were subjected to an initial weaning trial.
Results: As regard previous history of ventilator support and source of referral there was statistically non significant difference between the patients who failed and succeed weaning. As regard ventilator machine trade name there was statistically non significant difference for weaning success. There was statistically non-significant difference for weaning success regarding diaphragmatic ultrasound parameters (TDI, End inspiratory TDI and end expiratory TDI), but regarding diaphragmatic excursion there was significant difference. As regard Pi max and PaO2/FiO2 there was statistically significant difference for weaning success but regarding rapid shallow breathing index (RSBI) there was statistically non-significant difference. There was statistically non-significant difference for weaning success as regard method of weaning.
Conclusion: Weaning success is very high in specialized tertiary ICU; 91.7%. Pimax, PaO2/ FIO2 and diaphragmatic excursion are a good predictor for weaning success.

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