Risk factors by prolonged weaning by COPD GOLD D Patients
In our first single center retrospective, study from 2013 to 2018 18 patients with COPD GOLD D and massive emphysema obtained quantitative CT and Ventilation-perfusionsscintigraphy. There were 10 male (average age 66 and 34 pack years) and eight female (average age 67 and 35 pack years) patients. By dividing lung in upper, middle and lower part of each side computer-aided automated analytical software we could visualize emphysema by measure lung density (LAV, low-attenuation volume < -950 HU) in percent. Axial and coronal density masks image could show cluster of emphysema. The comparison of quantitative CT and Ventilation per fusion scintigraphy presented conformity of 92.86%. By patients with COPD GOLD D and massive emphysema on Respiratory Intensive Care unit (R-Intensive) with prolonged weaning using invasive ventilation with RSBI > 120 and by patients with long-term non-invasive ventilation the possibility of VIDD will increase. By invasive ventilated patients with massive emphysema and prolonged weaning selective lung-volume reduction surgery based on quantitative CT can relieve the diaphragmatic function, increase succeed of the weaning and reduce hospitalization duration. In the second Retrospective study in 2019, we treated 54 patients with prolonged Weaning by invasive ventilation via tracheal cannula or intensive NIV. From those we identified eight male with 74 average years and four female with average years 73 with anemia under Nine g/dl. From those there were six patients with COPD GOLD D and average anemia of 7.9 g/dl. By analysis of six patients with COPD GOLD D with anemia and prolonged weaning, we could see high mortality of 67% in compare to average 9% mortality of the whole 54 patients with prolonged weaning. Anemia under Eight g/dl seems to be a prognostic factor for survival by prolonged Weaning by COPD GOLD D patients.