Chronic Obstructive Pulmonary Disease (COPD)
Conditions
Keywords
Pulmonary Disease, Chronic Obstructive., Tracheostomy., Invasive Mechanical Ventilation., Non-Invasive Mechanical Ventilation.
Brief summary
The purpose of this study was to determine occurrence of ventilator associated pneumonia (VAP) in tracheostomized patients with COPD discharged in invasive mechanical ventilation (IMV) compared to patients with CPOPD discharged with tracheostomy but in non invasive mechanical ventilation (NIMV).
Detailed description
Acute respiratory failure due to COPD is often treated with invasive mechanical ventilation through endotracheal intubation, followed by placement of a endotracheal canula. However, invasive ventilation is at risk of infective complications and is difficult to manage at home. In particular, invasive mechanical ventilation may be associated with ventilator associated pneumonia (VAP). VAP is usually suspected when the individual develops a new or progressive infiltrate on chest radiograph, leukocytosis, and purulent tracheobronchial secretions. When possible, we tried to put these tracheotomized patients in non invasive mechanical ventilation (NIMV)to avoid VAP. This population was followed for eight consecutive years and compared with patients in invasive home mechanical ventilation (IMV).
Interventions
The above cited parameters were recorded and investigated every six months; chest X ray when needed.
Sponsors
Study design
Eligibility
Inclusion criteria
* Clinical diagnosis of COPD * Tracheostomy * Need of domiciliary invasive / non invasive ventilation
Exclusion criteria
* Patients with COPD weaned from invasive / non invasive mechanical ventilation * Lack of tracheostomy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| ventilator associated pneumonia (VAP) | six months | VAP is usually suspected when the individual develops a new or progressive infiltrate on chest radiograph, leukocytosis, and purulent tracheobronchial secretions. Therefore white cell blood (WBC)count, procalcitonine (PCT), C-reactive protein (CRP) and tracheobronchial aspirate (TBA) were collected every 6 months. Chest X ray was performed only when a clinical suspect of VAP was advanced. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Blood gas analysis | Six months | Blood gas analysis |
| Care givers involvement | Six months | Through a dedicated questionnaire |
Countries
Italy