The primary objective is to evaluate the mechanical power as a predictor of weaning of mechanical ventilation in COPD patients hospitalized in the respiratory intensive care unit of Assiut University Hospital.
The secondary objective is to compare between mechanical power and diaphragmatic excursion (DE) assessed by ultrasound as a predictor of weaning in these patients. Also, to investigate the association between MP and DE and mortality in these patients
None
Patients with Bronchiectasis, interstitial lung diseases, lung scarring.
Tracheostomized patients.
COPD patients who are mechanically ventilated in Respiratory ICU of Assiut University Hospital
Cohort
Prospective
Calculation of Mechanical Power.
Other interventionTotal respiratory rate (RR). Positive end-expiratory pressure (PEEP) (the external or applied PEEP) recorded, not the total PEEP, or intrinsic PEEP. The plateau pressure (Pplat) was measured during an inspiratory pause on the ventilator. Peak inspiratory pressure (Ppeak) should be obtained while the patient is relaxed, not coughing or moving in bed. MP was calculated according to Gattinoni's simplified mechanical power equation as follows (3,8): MP(J/min)=0.098×VT×RR×(Ppeak-0.5×ΔP).
Measurement Diaphragmatic Excursion after first SBT
Other interventionChest ultrasound to assess diaphragmatic excursion (DE(. M-mode was used to record the movement of the diaphragm during tidal breathing when the sampling line and diaphragm were as vertical as possible (not \< 70°). The data was measured from the first respiratory cycle at 0 min after SBT. The DE at 0 min, 5 min, and 30 min of SBT was respectively named as DE0, DE5, and DE30. The variation of right DE between each time point was named as ΔDE30-5 and ΔDE30-0. (7)
Calculation of Mechanical Power before first trial of extubation.
Calculation of Mechanical Power before first trial of extubation for every mechanically ventilated patient before first trial of extubation.
value of Mechanical Power in died patients.
Mechanical Power as a predictor of patient's mortality.
calculation of Mechanical Power in every Patients suffered from ventilator induced lung injury.
calculation of Mechanical Power and the number of Patients suffered from ventilator induced lung injury so study association between value of MP and possibility of VILI to be occurred.
Calculation of other parameters of weaning as Respiratory rate, Rapid shallow breathing index and expiratory tidal volume.
Correlation analysis between mechanical power and other parameters of weaning in evaluation of prognosis in COPD patients.
number of days for hospital stay and ICU stay for every Mechanically ventilated patients.
calculation of mechanical power and duration of hospital stay and ICU stay for each patient.
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