Effect Of Left Ventricular Dysfunction On Weaning Patients With Mechanical Ventilation In AECOPD

Objective To investigate the left ventricular dysfunction affects weaning of mechanical ventilation(MV)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods We selected 55 AECOPD patients of respiratory failure with mechanical ventilation from January 2012 to February 2015 of GICU in Central Hospital of Songjiang District.and were analyzed with retrospective cohort study.According to weaning or not after one week mechanical ventilation treatment is divided into two groups:weaning group of 43 cases and difficulty in withdrawing the mechanical ventilation of 12 cases.Monitoring hemodynamic index such as EVLWI,PVPI,CI,GEDVI,CFI,GEF.dPmx of patients with PiCCO before treatment and after one week.Then take a multivariate regression analysis to study the factors of Mechanical ventilation weaning.Results The weaning group after treatment compared with before treatment,EVLWI,Cl,CFI,GEDVI decreased,GEF,dPmx increased,the difference was statistically significant(p<0.05),There was no significant difference of PVPI with treatment.In the difficulty weaning group,showed no significant difference of EVLWI,PVPI,CI,GEDVI,CFI,GEF,dPmx before treated with MV compared to after treatment(p>0.05).After one week treatment,the index of EVLWI and GEDVI were lower,while the index of CI,CFI,GEF and dPmx were higher in weaning group.The difference was statistically significant(p<0.05).The results of Logistic regression analysis shows that EVLWI,CFI,GEF are the independent risk factors of difficulty weaning in AECOPD patients with MV after one week.Conclusion Left ventricular dysfunction and concomitant pulmonary edema is important factors of difficult weaning in respiratory failure of AECOPD patients.PiCCO provided the technology to monitor the index of EVLWI,CFI,GEF which can detect left ventricular function of patients and predict difficulty weaning.It could guild mechanical ventilation in AECOPD patients with respiratory failure.