Assessment of the outcome of mechanically ventilated chronic obstructive pulmonary disease patients admitted in the respiratory ICU in Ain Shams University Hospital

Background Mechanical ventilation (MV) alters the outcome of patients with chronic obstructive pulmonary disease (COPD). Aim This study aimed to assess the outcome of mechanically ventilated COPD patients admitted in the respiratory ICU and the factors influencing the outcome. Patients and methods This prospective study included 50 mechanically ventilated COPD patients. For all patients, arterial blood gas analysis and vital data (before intubation, before extubation, and 30 min after extubation), complications of MV, the length of ICU stay, duration of MV, different trials of weaning from MV, and outcome were documented. Results Nonsurvivors were significantly older (68.1 ± 10.3 vs. 60.7 ± 11.1, P = 0.034), had longer duration of MV (11.8 ± 10.4 vs. 5.4 ± 5.2, P = 0.02), prolonged ICU stay (17.7 ± 10.2 vs. 9.3 ± 5.6, P = 0.01), more frequent tracheostomy (4 vs. 1, P = 0.018), less liable to be weaned from the first trial (5 vs. 28, P = 0.008), and more complications of MV ( P = 0.04). Only PaCO 2 before intubation differed significantly between survivors and nonsurvivors (92.6 ± 14.9 vs. 81.0 ± 18.2, P = 0.025). The length of ICU stay correlated significantly with both systolic and diastolic blood pressure ( P = 0.009 and 0.022, respectively), complications of MV ( P = 0.001), and the duration of MV ( P = 0.0001). Conclusion Several predictors can affect the outcome of COPD patients on MV, ultimately increasing the length of stay and mortality rate, including age, failure of several trials of weaning, presence of ventilator-associated pneumonia, adult respiratory distress syndrome, presence of tracheostomy, and prolonged MV duration.