ORIGINAL ARTICLE
Year : 2014  |  Volume : 8  |  Issue : 1  |  Page : 44-50

Evaluation of the cardiopulmonary status using a noninvasive respiratory profile monitor in chronic obstructive lung disease patients during low-ventilation strategy


1 Department of Chest Diseases, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Department of Chest, Abbassia Chest Hospital, Cairo, Egypt

Correspondence Address:
Adel M Saeed
Department of Chest Diseases, Faculty of Medicine, Ain Shams University, 11211 Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1687-8426.137351

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Background Patients with chronic obstructive pulmonary disease (COPD) patients are susceptible to complications, especially volutrauma, during the period of mechanical ventilation; low ventilation is a safe strategy to avoid these complications. Noninvasive capnography is a suitable technique for monitoring and assessing the cardiac and the pulmonary status of these patients during the period of mechanical ventilation. ObjectivesAssessment of the cardiac and the pulmonary status of two COPD patient groups receiving mechanical ventilation with a low tidal volume strategy using a noninvasive CO 2 respiratory profile monitor (volumetric capnography). Patients and methods Forty patients were recruited in the respiratory ICU of Abbassia Chest Hospital; these patients were divided into two groups: 20 COPD patients with the predominant pathology of chronic bronchitis (CB) and 20 patients with the predominant pathology of emphysema disease, who presented with clinical and radiological evidence of chronic obstructive lung disease and were in need of mechanical ventilation. All the patients in the study were followed up three times per day until weaning; data were recorded on admission, after 24 h and before weaning using volumetric capnography. Results There was significant correlation between EtCO 2 and arterial PCO 2 during the whole period of mechanical ventilation in CB and emphysematous patients; the mean dead-space fraction was significantly higher in the emphysema group than in the CB group. There was a significant negative correlation between the mean values of Vd/Vt and the pulmonary capillary blood flow on admission and after 24 h in the emphysema group. The mean cardiac output, the mean stroke volume, and the pulmonary capillary blood flow increased significantly before extubation in the CB group, in contrast to the emphysema group in which there was an insignificant difference. Conclusion Volumetric capnography could be helpful in assessing the severity of functional disturbances, and the use of more refined noninvasive parameters will be of value in managing and monitoring COPD patients during the whole period of mechanical ventilation.


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