Advertisment Fosfocin
Indian Journal of Critical Care Medicine
An open access publication of ISCCM™ 
Users online: 628 
     Home | Login 
  About Current Issue Archive Search Instructions Online Submission Subscribe Etcetera Contact  
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded608    
    Comments [Add]    
    Cited by others 2    

Recommend this journal


Year : 2006  |  Volume : 10  |  Issue : 2  |  Page : 88--94

Predictors of need of mechanical ventilation and reintubation in patients with acute respiratory failure secondary to chronic obstructive pulmonary disease

1 Department of Medicine, All India institute of Medical Sciences, New Delhi, India
2 Medical Research Specialists, Medical & Research Division, Pfizer Limited, India

Correspondence Address:
G C Khilnani
Department of Medicine, All India institute of Medical Sciences, New Delhi - 110 029
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-5229.25921

Rights and Permissions

Background and Aims: To identify predictors of need of mechanical ventilation (MV) and that of reintubation, after a planned extubation, among the patients with exacerbation of chronic obstructive pulmonary disease. Materials and Methods: Prospectively collected data of 82 patients with exacerbation of COPD over a one-year period were reviewed. Clinical and demographic profile, APACHE II score, blood gas parameters and serum biochemistry, recorded at the time of admission, were compared between patients who required MV and those who did not. Parameters were also compared between the groups formed on the basis of requirement of reintubation. Results: Sixty-nine patients (84.1%) required invasive MV. Independent predictors of need of MV were pH<7.26 (adjusted OR, 95% CI) (4.9, 1.1-21.3; P =0.03) and SA < 3.5 g/dL (6.3, 1.4-27.7; P =0.01). Reintubation was required in 8 patients out of 45, who were extubated (17.8%). PaCO2 rise 12 hours after extubation (1.25, 1.0-1.5; P =0.01) and APACHE II score (1.33, 1.0-1.7; P =0.03) were independent predictors for need of reintubation. A cut off level of 7.2 mmHg for PaCO2 rise had sensitivity of 100% and specificity of 84%,for need of reintubation. Conclusions : Presence of acidemia and hypoalbuminemia at admission are predictors of need of MV, whereas APACHE II score at baseline and PaCO2 rise in the initial 12 hours after extubation, predict need of reintubation.


Print this article     Email this article

Online since 7th April '04
Published by Wolters Kluwer - Medknow