Effect of Tuberculous Destroyed Lung on Lung Mechanics and Weaning in Patients with Chronic Obstructive Pulmonary Disease during Mechanical Ventilation
의약학 > 내과학
박동원 , 송준석 , 김웅준 , 곽현정 , 문지용 , 김태형 , 김상헌 , 윤호주 , 신동호 , 박성수 , 손장원
대한결핵 및 호흡기학회
대한결핵및호흡기학회 추계학술발표초록집 2012년, 제114권 182(총1페이지)
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    Background: The patients with tuberculous destroyed lung (TDL) account for a significant portion of those with chronic obstructive pulmonary disease (COPD) and may commonly experience acute exacerbation with respiratory failure in an intermediate burden area of tuberculosis (TB), such as South Korea. We investigated the effect of TDL on lung mechanics and weaning in patients with COPD during mechanical ventilation. Methods: We reviewed the medical records of patients with TDL having an obstructive pattern on a previous pulmonary function test and patients with COPD without history of TB, who were admitted to the ICU. Results: Of 11 enrolled patients, 5 patients (mean age 72.8±7.6) were COPD with TDL and 6 patients (mean age 66.3±6.7) were COPD without TDL. There`s no significant difference in level of auto-PEEP between two groups. Level of static compliance in patients with TDL was significantly lower than those without TDL (29.4±12.8 ml/cmH20 vs. 52.4±13.6 ml/cmH20, p=0.018). Airway resistance in patients with TDL was significantly higher than those without TDL (31.6±13.2 cmH20/L/sec vs. 14.4±4.0 cmH20/L/sec, p=0.014). The median duration of mechanical ventilation was 16.6 days in patients with TDL and 28.8 days in those without TDL (p=0.23). But, of all studied patients with COPD, the duration of mechanical ventilation was significantly associated with static compliance (r=0.723, p=0.012). Conclusion: In patients with COPD during mechanical ventilation, the presence of TDL were associated with low level of static compliance and high level of airway resistance.
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