Volume : VII, Issue : IX, September - 2017

FIRST DAY PREDICTORS OF REQUIREMENT OF MECHANICAL VENTILATION IN COPD PATIENTS WITH ACUTE EXACERBATION

Dhanus Sadasivan Nair, Victor Theophilus Premkumar

Abstract :

 

CONTEXT

Since burden of COPD vastly outnumbers the critical care facilities in India, identification on the day of admission itself of those patients with acute exacerbations of COPD will allow the physician to properly utilize these precious resources for deserving patients

 

AIM OF THE STUDY

  To identify the first day predictors of requirement of mechanical ventilation in

COPD patients with acute exacerbation.

 

SETTINGS AND DESIGN :

 Prospective study

 

MATERIALS AND METHODS

All the patients will undergo detailed clinical evaluation, appropriate investigations.

The demographic profile collected by questionnaire at the time of admission will include age, sex, smoking status. Patient vitals including heart rate, blood pressure and respiratory rate will be recorded. Premorbid functional status according to the modified Menzies criteria will be calculated from the patient or relatives if the patient is unable to provide the details. Arterial blood gas analysis, liver function tests, renal function tests, serum electrolytes will be done routinely for the patients. Acute Physiology and Chronic Health Evaluation II ( APACHE II) score will be calculated for each patient from the following data (Age, Temperature, Mean Arterial Pressure, Heart Rate, Respiratory Rate, FiO2, Arterial pH, Serum HCO3, Serum sodium, Serum Potassium, Serum Creatinine, Packed Cell Volume, WBC count, Glasgow Coma Scale). All patients were treated with the same initial measures and intubated only if they fit into indications for mechanical ventilation. Finally the parameters were compared between those patients treated conservatively and those who eventually needed mechanical

ventilation.

 

STATISTICAL ANALYSIS

One way ANOVA, Pearson correlation and Chi square test.

 

RESULTS

In our study the association between duration of cigarette smoking,high PaCO2,high APACHE II,low pH,low serum albumin,high premorbid score,low GCS and the need for mechanical ventilation was found to be significant

 

CONCLUSIONS

Hence, our study has found that duration of smoking in pack years, first day values of arterial blood pH, PaCO2, Glasgow Coma Scale, APACHE II score, serum albumin and premorbid functional status can be used to predict the need for mechanical ventilation in COPD patients with acute exacerbation. 

Keywords :

Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Dhanus Sadasivan Nair, Victor Theophilus Premkumar, FIRST DAY PREDICTORS OF REQUIREMENT OF MECHANICAL VENTILATION IN COPD PATIENTS WITH ACUTE EXACERBATION, INDIAN JOURNAL OF APPLIED RESEARCH : Volume-7 | Issue-9 | September-2017

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