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[Mechanical ventilation of advanced chronic obstructive pulmonary disease patients with recurrent severe respiratory
Objective:
To summarize the results of patients of severe respiratory failure using multiple times mechanical ventilation (MV) via tracheal intubation (or via tracheotomy).
Methods:
We retrospectively analysed clinical information and follow-up results of 15 acute exacerbation of COPD patients using MV more than 3 times.
Results:
MV was used 77 times in 15 patients. The highest number of MV was 20.86% were weaned successfully. The mean duration of MV via intubation was 13 days and via tracheotomy was 37 days, mean 649 days via the latest brocheotomy after using MV multiple times. The survival duration after the first MV varied from 196 to 4 420 days in 15 patients, mean 1 093 days, medium survival duration of the patients was 1 673 days, survival rates after 1, 2, 3 and 5 years were 73%, 64%, 33% and 25% respectively. The causes of death were failure of multiple organs or disfunction of other vital organs.
Conclusions:
Repeated application of MV may prolong the survival rates of COPD with severe respiratory failure. It's important to take strictly the indication of MV, correctly to select the methods of artificial airway, combining invasive and noninvasive ventilation, properly to apply the strategies of MV.