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Medicas UIS

Print version ISSN 0121-0319On-line version ISSN 1794-5240

Abstract

CENTENO-HURTADO, Katherine Tatiana et al. Characteristics of patients with severe acute exacerbation of chronic obstructive pulmonary disease who required invasive mechanical ventilation in a Santander hospital during 2014-2020. Medicas UIS [online]. 2023, vol.36, n.1, pp.9-19.  Epub Apr 25, 2023. ISSN 0121-0319.  https://doi.org/10.18273/revmed.v36n1-2023001.

Introduction:

Chronic obstructive pulmonary disease is airflow limitation due to alveolar abnormalities. In an acute exa- cerbation, non-invasive mechanical ventilation is the first line of management, however, there are certain risk factors that make the use of invasive mechanical ventilation more likely in these patients, which are not adequately described in the scientific literature and that can guide towards a choice of appropriate ventilatory support.

Objective:

To describe the factors that were associated with an increased need for invasive mechanical ventilation in a cohort of hospitalized patients with an acute exacerbation of chronic obstructive pulmonary disease.

Methods:

Cross-sectional analytical observational study, with non-probabilistic sampling including all patients who consulted the emergency room and were hospitalized for acute exacerbation of chronic obstructive pulmonary disease in a tertiary care hospital in Santander-Colombia during the period 2014-2020.

Results:

81 patients were included, 36 required non-invasive mechanical ventilation and 12 invasive me- chanical ventilation. 25 % of the patients with non-invasive mechanical ventilation failed the initial therapy and demanded the use of invasive mechanical ventilation. The most frequent comorbidities were arterial hypertension (70.3 %) and heart disease (49.38 %). 70 % had been exposed to smoking as direct smokers.

Conclusions:

The use of invasive mechanical ven- tilation was associated in a statistically significant way in patients with a profile of: severe dyspnea, acidosis by gasometric parameters, antibiotic escalation, use of intravenous corticosteroids, intensive care unit requirement, infections associa- ted with health care and prolonged hospital stay.

Keywords : Recurrence; Pulmonary Disease; Chronic Obstructive; Respiration; Artificial; Critical Care; Interactive Ventilatory Support.

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