Prognosis and evaluation of patients with chronic obstructive pulmonary disease intubated in intensive care unit

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is the third most common cause of death worldwide. It is important to prevent this problem from a human as well as an economic point of view. With ever-increasing number of people requiring hospitalization, there is a need to increase intervention and treatment facilities and to develop new treatment approaches necessary to reduce mortality. We evaluated the course of the disease of patients who were already admitted to the intensive care unit with respiratory failure due to COPD, underwent acute exacerbation requiring intubation and invasive mechanical ventilation (IMV). Methodology: Our study included 149 patients who were admitted to the intensive care unit with respiratory failure due to COPD exacerbation only, who underwent intubation and IMV while being followed up in the intensive care unit. The demographic data of patients diagnosed with COPD before hospitalization, length of stay in the intensive care unit and service, comorbid diseases, type of respiratory support device before IMV, current pneumonia status during exacerbation, and laboratory values ​​were recorded. The relationship between the in-hospital exacerbation in COPD and the prognosis was evaluated. Results: The mean intensive care unit stay of these patients was 3.74 ± 4 days. Reintubation was needed in 56 patients (37.6%), 30 patients (20%) could not survive. A statistically significant difference was found between pneumonia developing in the hospital and the mortality (P = .01). Conclusion: While studies are ongoing for the prevention of COPD exacerbations, more studies are needed to develop approaches and treatments for patients with COPD who develop acute respiratory failure due to their existing disease and need intensive care, as the associated mortality is very high. Abbreviations:  COPD - Chronic obstructive pulmonary disease; IMV - Invasive mechanical ventilation; HFNC - High Flow Nasal Cannula; NIMV - Non-invasive mechanical ventilation; CRP – C-Reactive protein; GOLD - Global Initiative for Chronic Obstructive Lung Disease Key words: Intubation; Invasive mechanical ventilation; Chronic Obstructive Pulmonary Disease; COPD; High Flow Nasal Cannula; HFNC Citation: Kilinç M, Yildiz M, Mentes O, Durmaz G. Prognosis and evaluation of patients with chronic obstructive pulmonary disease intubated in intensive care unit. Anaesth. pain intensive care 2022;26(4):474-479. DOI: 10.35975/apic.v26i4.1950 Received: January 12, 2022; Reviewed: January 19, 2022; Accepted: February 09, 2022.