Factors affecting the success of weaning in patients with chronic obstructive pulmonary disease
Journal Title: Dicle Tıp Dergisi - Year 2011, Vol 38, Issue 3
Abstract
Objectives: Weaning failure rate was higher in patients with chronic obstructive pulmonary disease (COPD) and many factors affect it. The aim of this study was to investigate the factors affecting the success of weaning in COPD patients receiving invasive mechanical ventilation (IMV). Materials and methods: Totally 43 COPD patients who received IMV in intensive care unit were included. Clinical and laboratory results and Acute Physiology Assessment and Chronic Health Evaluation (APACHE II) scores were recorded and affecting factors on weaning success were investigated. Results: In 43 patients, 25 had successful weaning (58.1%). Patients with high APACHE II score prior to intubation was found as associated with weaning failure. High Glasgow coma scale (GCS) scores before entubation and weaning are associated with weaning success. Pre-weaning anxiety, positive endotracheal aspirate culture, pulmonary arterial pressure value, enteral feeding, pre-weaning tachycardia, pre-weaning cuff leaking and FiO2 values were found to be associated with weaning failure. Pre-weaning cortisol levels were associated with weaning success. In successful weaning group, measured NIF and VT in spontaneous mode were found as higher and f/VT ratio was lower compared with unsuccessful group. T-tube during the 15th and 30th minutes of the symptoms of fatigue (sweating assets) were associated with weaning failure. IMV duration and longer extubation duration of weaning, and more number of t-tube insertion attempts were found as associated with failure of weaning. Conclusions: Infection in patients with COPD, the presence of anxiety, and hemodynamic and respiratory instability significantly increases the weaning failure.
Authors and Affiliations
Turgut Teke, Rukiye Metineren, Emin Maden, Kürşat Uzun
Keywords
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