Clinical outcome of weaning in mechanically ventilated patients with chronic obstructive pulmonary disease

Abstract

BackgroundChronic obstructive pulmonary disease (COPD) represents a significant reason for mortality and morbidity worldwide that induces a high socioeconomic burden, with exacerbations necessitating mechanical ventilation representing a major aspect of illness management. Many patients with COPD frequently presented with troubles in the liberation from mechanical ventilation. The aim of the current study was to verify the validity of the weaning categorization that is classified according to the difficulty and length of the weaning procedure in mechanically ventilated patients with COPD and its effect on the different clinical and mortality outcome variables.Patients and methodsA total of 102 patients with COPD who achieved the weaning criteria were classified according to the length and difficulty of weaning procedure into simple weaning group (n=60, 58.8%) and nonsimple weaning group (which include difficult and prolonged weaning categories) (n=42, 42.2%). The outcome measures are the length of mechanical ventilation, the duration of ICU stay, and lastly the mortality rate.ResultsRegarding baseline data recorded at admission, no significant difference between both weaning groups was found apart from Acute Physiology and Chronic Health Evaluation score II. The nonsimple weaning group had considerably higher duration of invasive mechanical ventilation, length of ICU stays, and lastly the mortality rate, in comparison with the simple weaning group.ConclusionWeaning categorization according to the length and the difficulty of the weaning procedure may be used as a suitable predictor of outcome in severe COPD exacerbation with the requirement for invasive mechanical ventilation.