A Report of Separation From Mechanical Ventilation in a Patient With Chronic Obstructive Pulmonary Disease (COPD)
Jundishapur Journal of Chronic Disease Care: 2 (4); 32248
November 15, 2013
Article Type: Case Report
November 13, 2012
November 29, 2012
T. A Report of Separation From Mechanical Ventilation in a Patient With Chronic Obstructive Pulmonary Disease (COPD),
Jundishapur J Chronic Dis Care.
Online ahead of Print
Chronic Obstructive Pulmonary Disease (COPD) is a chronic disorder with many systematic complications and one of the most important reasons for patients to require mechanical ventilation, admission in intensive care unit and prolonged mechanical ventilation. Although the first attempt in separation of mechanical ventilation is failed in half of chronic obstructive pulmonary disease (COPD) patients, but delaying in the weaning process in these patients also cause ventilator dependence. PaCO 2 = 35 - 60 mm/Hg is one of the most important indexes for predicting a successful extubation.
A 49-year-old man and known case of COPD who was supported by mechanical ventilation following to bronchopneumonia and severe respiratory infection. After 9 days, followed by gradual reduction of ventilatory support, the patient was placed on Spontaneous Mode with 15 cm/H 2O pressure support. Due to satisfactory consciousness and stable hemodynamic status, in spite of high PaCO 2 (PaCO 2 > 115), weaning was done on the 11th day of hospitalization. Patient was discharged from ICU with satisfactory breathing and clinical status one week after the extubation.
Regarding the results of this report, it could be stated that because of the compatibility generated in COPD patients in the endurance of the high levels of PaCO 2, in case satisfactory consciousness and stable hemodynamic condition of patients, the option of successful weaning could be considered. Additionally, it is suggested that clinician experience and his clinical judgment in addition to predictor indexes for successful weaning be utilized.
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