Clinical study on criteria for applying mechanical ventilatory support and selection of ventilatory modes in the patients with acute exacerbation of chronic obstructive pulmonary disease (COPD)

Abstract

Two hundred and thirty consecutive episodes of acute exacerbations in 126 COPD patients (male 76, female 50, : average age 71.4 yrs and 74.8 yrs respectively) were treated according to the therapeutic protocals made by our own.
110 episodes in 51 patients required mechanical ventilatory support, mainly because they developed disturbance in consciousness, abnormality in respiratory rate (over 40 or below 6), inability of bringing up in addition to severe hypercapnia or refractory severe hypoxemia.
Ventilatory modes were selected according to the type of respiratory failure. Thus, assisted or controlled ventilatory modes for acute Type II and IMV (Intermittent Mandatory Ventilation) for mixed one (acute respiratory failure on chronic one).
Weaning was made by on-off method for acute Type II and gradual reduction in frequency of IMV along with muscle powering exercise for mixed one.
The survived cases among those apllied IMV mode were successfully weaned in average days of 10.5 and overall mortality rate for those mechainivally ventilated was 27.7%.