Source: Annual Congress 2001 - Monitoring acute lung disease
Disease area: Airway diseases, Respiratory critical care

Abstract

The aim of prospective study was to find out the parameters, which can help us to predict the outcomes of treatment of severe COPD exacerbations in ICU.
Authors evaluated a group of 64 patients (50 without and 14 with mechanical ventilation /MV/). FEV₁, PaO₂, PaCO₂, pH, serum concentration of theophylline, lactate, hematocrit were measured on admission and then every day during the hospitalization in ICU.
Patients without necessary MV had on admission significantly higher values of PaO₂ (8,5 ±]1,6 kPa) than those with necessary MV (6,4±] 2,0, p< 0,01). They also had significantly lower values of PaCO₂ (5,2 ±] 0,9 kPa) than ventilated persons (6,7 ±] 1,6 kPa, p< 0,01). After 24 hours of treatment in the group of non ventilated patients the FEV₁% of predicted value significantly increased (24,8 ±] 13,9 on admission, 40,6 ±] 17,7, p< 0,01 after 24 hours). After 24 hours of treatment both subgroups differed in the values of PaO₂ and PaCO₂. The mean value of PaO₂ in ventilated patients was 6,7 ±] 2,0 kPa, in the non ventilated ones 9,5 ±] 2,0 kPa (p <0,01). The mean value of PaCO₂ in ventilated patients was 8,2 ±]2,0 kPa, in non- ventilated ones was 5,3±] 0,8 kPa (p< 0,01).
On the subgroup of ventilated patients differed from the subgroup of non ventilated one on admission, and after 24 hours they differed in the values of blood gases. Authors didn¢t find out any cut-off values of measured parameters, which allow to predict, which patient has to be ventilated.

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Citations should be made in the following way:
J. Musil, V. Vondra (Prague, Czech Republic). Can we predict the outcomes of treatment of patients with severe exacerbation of chronic obstructive pulmonary disease (COPD)?. Eur Respir J 2001; 16: Suppl. 31, 1651

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