Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin’s adjunct role

How to identify the optimum switch point of sequential invasive and noninvasive ventilation is the focus of clinical attention on the patients suffering from acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by acute respiratory failure (ARF). This study aims to explor...

Full description

Bibliographic Details
Main Authors: Shao-Hua Lin, Ying-ping He, Jun-Jie Lian, Cun-Kun Chu
Format: Article
Language:English
Published: Taylor & Francis Group 2021-01-01
Series:Libyan Journal of Medicine
Subjects:
Online Access:http://dx.doi.org/10.1080/19932820.2021.1961382
id doaj-cffb144c5acf44db9668d67dbc5ab0ea
record_format Article
spelling doaj-cffb144c5acf44db9668d67dbc5ab0ea2021-08-09T15:50:07ZengTaylor & Francis GroupLibyan Journal of Medicine1993-28201819-63572021-01-0116110.1080/19932820.2021.19613821961382Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin’s adjunct roleShao-Hua Lin0Ying-ping He1Jun-Jie Lian2Cun-Kun Chu3Rongcheng Hospital Affiliated to Shandong First Medical UniversityRongcheng Hospital Affiliated to Shandong First Medical UniversityRongcheng Hospital Affiliated to Shandong First Medical UniversityShandong First Medical University & Shandong Academy of Medical SciencesHow to identify the optimum switch point of sequential invasive and noninvasive ventilation is the focus of clinical attention on the patients suffering from acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by acute respiratory failure (ARF). This study aims to explore the clinical significance of taking the change rate of procalcitonin (PCT) as identifying the timing of weaning on the mechanical ventilation for the patients of AECOPD followed by ARF as a complication. There were altogether 140 patients of AECOPD complicated with ARF, who were randomly selected and divided into a study group and a control group respectively. A change rate of serum PCT level exceeding 50% was taken as the switch point selection of tracheal intubation removal for the patients of the study group, while the ‘pulmonary infection control (PIC) window’ was done for those in the control group. With CRP, IL-6, TNF-a, PaCO2, PaO2, and Lac having been detected before and after treatment to them all, clinical indexes were obtained and compared between these two groups. The CRP, TNF-a, and IL-6 levels of the patients in the study group after treatment (p < 0.05) were lower than those in the control group. There was no significant difference in PaCO2, PaO2, and Lac between these two groups before and after treatment (p > 0.05). Even so, some other indexes available for the study group of patients were found to be lower than those for the control group (p < 0.05) in the following aspects: duration of invasive ventilation support, total time of mechanical ventilation support, incidence rate of ventilator-associated pneumonia, 48-hour reintubation rate, incidence rate of upper gastrointestinal bleeding, hospitalization time of critical respiratory illness, total hospitalization time, RICU treatment cost, total treatment cost, and mortality. It is preferable to take the change rate of PCT level exceeding 50% as the switch point of weaning time in sequential mechanical ventilation rather than the PIC window. Abbreviations AECOPD: acute exacerbation of chronic obstructive pulmonary disease; ARF: acute respiratory failure; PCT: procalcitonin; PaO2: the oxygen partial pressure; PaCO2: the partial pressure of carbon dioxide; TNF-a: serum tumor necrosis factor-a; IL-6: interleukin-6; CRP: serum C-reactive protein; PIC window: pulmonary infection control window; RICU: respiration and intensive care unithttp://dx.doi.org/10.1080/19932820.2021.1961382acute respiratory failurepulmonary infection control windowinvasive ventilation support therapytiming of weaningprocalcitoninkinetics
collection DOAJ
language English
format Article
sources DOAJ
author Shao-Hua Lin
Ying-ping He
Jun-Jie Lian
Cun-Kun Chu
spellingShingle Shao-Hua Lin
Ying-ping He
Jun-Jie Lian
Cun-Kun Chu
Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin’s adjunct role
Libyan Journal of Medicine
acute respiratory failure
pulmonary infection control window
invasive ventilation support therapy
timing of weaning
procalcitonin
kinetics
author_facet Shao-Hua Lin
Ying-ping He
Jun-Jie Lian
Cun-Kun Chu
author_sort Shao-Hua Lin
title Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin’s adjunct role
title_short Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin’s adjunct role
title_full Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin’s adjunct role
title_fullStr Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin’s adjunct role
title_full_unstemmed Procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin’s adjunct role
title_sort procalcitonin kinetics to guide sequential invasive-noninvasive mechanical ventilation weaning in patients with acute exacerbation of chronic obstructive pulmonary disease and respiratory failure: procalcitonin’s adjunct role
publisher Taylor & Francis Group
series Libyan Journal of Medicine
issn 1993-2820
1819-6357
publishDate 2021-01-01
description How to identify the optimum switch point of sequential invasive and noninvasive ventilation is the focus of clinical attention on the patients suffering from acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by acute respiratory failure (ARF). This study aims to explore the clinical significance of taking the change rate of procalcitonin (PCT) as identifying the timing of weaning on the mechanical ventilation for the patients of AECOPD followed by ARF as a complication. There were altogether 140 patients of AECOPD complicated with ARF, who were randomly selected and divided into a study group and a control group respectively. A change rate of serum PCT level exceeding 50% was taken as the switch point selection of tracheal intubation removal for the patients of the study group, while the ‘pulmonary infection control (PIC) window’ was done for those in the control group. With CRP, IL-6, TNF-a, PaCO2, PaO2, and Lac having been detected before and after treatment to them all, clinical indexes were obtained and compared between these two groups. The CRP, TNF-a, and IL-6 levels of the patients in the study group after treatment (p < 0.05) were lower than those in the control group. There was no significant difference in PaCO2, PaO2, and Lac between these two groups before and after treatment (p > 0.05). Even so, some other indexes available for the study group of patients were found to be lower than those for the control group (p < 0.05) in the following aspects: duration of invasive ventilation support, total time of mechanical ventilation support, incidence rate of ventilator-associated pneumonia, 48-hour reintubation rate, incidence rate of upper gastrointestinal bleeding, hospitalization time of critical respiratory illness, total hospitalization time, RICU treatment cost, total treatment cost, and mortality. It is preferable to take the change rate of PCT level exceeding 50% as the switch point of weaning time in sequential mechanical ventilation rather than the PIC window. Abbreviations AECOPD: acute exacerbation of chronic obstructive pulmonary disease; ARF: acute respiratory failure; PCT: procalcitonin; PaO2: the oxygen partial pressure; PaCO2: the partial pressure of carbon dioxide; TNF-a: serum tumor necrosis factor-a; IL-6: interleukin-6; CRP: serum C-reactive protein; PIC window: pulmonary infection control window; RICU: respiration and intensive care unit
topic acute respiratory failure
pulmonary infection control window
invasive ventilation support therapy
timing of weaning
procalcitonin
kinetics
url http://dx.doi.org/10.1080/19932820.2021.1961382
work_keys_str_mv AT shaohualin procalcitoninkineticstoguidesequentialinvasivenoninvasivemechanicalventilationweaninginpatientswithacuteexacerbationofchronicobstructivepulmonarydiseaseandrespiratoryfailureprocalcitoninsadjunctrole
AT yingpinghe procalcitoninkineticstoguidesequentialinvasivenoninvasivemechanicalventilationweaninginpatientswithacuteexacerbationofchronicobstructivepulmonarydiseaseandrespiratoryfailureprocalcitoninsadjunctrole
AT junjielian procalcitoninkineticstoguidesequentialinvasivenoninvasivemechanicalventilationweaninginpatientswithacuteexacerbationofchronicobstructivepulmonarydiseaseandrespiratoryfailureprocalcitoninsadjunctrole
AT cunkunchu procalcitoninkineticstoguidesequentialinvasivenoninvasivemechanicalventilationweaninginpatientswithacuteexacerbationofchronicobstructivepulmonarydiseaseandrespiratoryfailureprocalcitoninsadjunctrole
_version_ 1721213693394419712