Case Reports Of Two Difficult Weaning Patients With AECOPD And Literature Review

Objectives:Through the discussion about the causes, management, assessment and weaning method of difficult weaning of AECOPD patients with mechanical ventilation,this paper aims to raise the success rate of weaning and provide constructive ideas for the individualization of weaning strategies for mechanical ventilation patients with AECOPD by strengthening clinicians’ understanding of the characteristics of this disease and normalized weaning.Methods:Review and analyse 82 cases of mechanical ventilation in AECOPD patients medical records in the first hospital of Shanxi Medical University from 2008 to 2013.According to difficulty level of weaning and weaning time, the offline patient were divided into simple offline and difficult offline, prolonged offline 3 class.The differences of the three types of patients in different gender, age were analyzed.Observe and record the main reason of weaning failure,such as the lung infection, airway nursing, Pulmonary heart disease and hypothyroidism, hypoproteinemia and amalnutrition, electrolyte acid-base balance disorders, psychological and improper offline strategy and calculate the constituent ratio,while attached to 2 cases report of AECOPD mechanical ventilation difficult weaning patients.Results:Among 82 cases of AECOPD patients with mechanical ventilation, there are 47 cases of simple weaning(57.6%), 26 cases of difficult weaning(31.7%), 9 cases of prolonged weaning(11.0%);Age difference has stiatistical significance(P < 0.001) between the simple offline and difficult weaning patients.Age difference has statistical significance(P< 0.001) between simple weaning and prolong weaning patients.Age difference has no stiatistical significance(P=0.747) between difficult weaning and extend weaning.Among mechanical ventilation patients with AECOPD,men are more than women on the whole,but gender constitute differences have no statistical significance among the three categories of patients.In 35 cases of weaning failure patients, there are 9 cases of pulmonary infection(25.7%), 4 cases of airway nursing(11.4%),5 cases of pulmonary heart disease(14.3%), 1case of hypothyroidism(2.8%),8 cases of hypoproteinemia and malnutrition(22.9%),3cases of electrolyte and acid-base balance disorders(8.6%), 3 cases of psychological(8.6%),2 cases of improper weaning(5.7%).Conclusions:Among AECOPD patients with mechanical ventilation in our hospital, difficult weaning and prolonged weaning accounted for a total of 42.7%, in weaning failure patients,the most common reason is pulmonary infection.