Review of ventilatory techniques to optimize mechanical ventilation in acute exacerbation of chronic obstructive pulmonary disease

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Authors: Raghu M Reddy, Kalpalatha K Guntupalli

Published Date January 2007 Volume 2007:2(4) Pages 441 - 452

DOI: http://dx.doi.org/10.2147/COPD.S

Raghu M Reddy, Kalpalatha K Guntupalli

Pulmonary Critical Care and Sleep Medicine Section, Ben Taub General Hospital, Baylor college of Medicine, Houston, TX, USA

Abstract: Chronic obstructive pulmonary disease (COPD) is a major global healthcare problem. Studies vary widely in the reported frequency of mechanical ventilation in acute exacerbations of COPD. Invasive intubation and mechanical ventilation may be associated with significant morbidity and mortality. A good understanding of the airway pathophysiology and lung mechanics in COPD is necessary to appropriately manage acute exacerbations and respiratory failure. The basic pathophysiology in COPD exacerbation is the critical expiratory airflow limitation with consequent dynamic hyperinflation. These changes lead to further derangement in ventilatory mechanics, muscle function and gas exchange which may result in respiratory failure. This review discusses the altered respiratory mechanics in COPD, ways to detect these changes in a ventilated patient and formulating ventilatory techniques to optimize management of respiratory failure due to exacerbation of COPD.

Keywords: COPD, chronic obstructive pulmonary disease, mechanical ventilation, acute exacerbation, waveforms