The effectiveness of long-term respiratory support in a patient after pneumonectomy

I. Mukatova, A. S. Serikova, G. S. Nuralieva, S. N. Avdeev
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Abstract

Respiratory support for chronic respiratory failure in the last stages is widely used, most often in patients with end-stage COPD. It has been proven that the development of chronic hypercapnic respiratory failure is associated with an increasing in exacerbations, increased hospitalization rates, and an acceleration of the time before subsequent decompensation. Also hypercapnia isa determining factor in mortality. Effective treatment method of hypercapnic insufficiency is non-invasive ventilation. Long-term non-invasive ventilation improves daytime hypercapnia, quality of life, increases the period until the next severe exacerbation and survival of patients with COPD. Patients with COPD have different phenotypes and various comorbid diseases, which which may be challenging while choosing method of respiratory support and assessing the effectiveness of this treatment method. There is lack of data on long-term non-invasive respiratory support for patients with COPD after pneumonectomy in chronic period. Most of publications dedicated for early post-operative period after pneumonectomy. The purpose of this publication is to present a case of successful long-term non-invasive ventilation combined with oxygen therapy in a patient with COPD and bronchiectasis of a single lung. Stages of management of hypoxemic and subsequently developed hypercapnic chronic respiratory failure are reflected. We demonstrate experience of successful long-term ambulatory non-invasive ventilation in a patient with chronic hypercapnic respiratory failure as a result of COPD and pneumonectomy was demonstrated. Observation study showed feasibility of combined respiratory support in outpatient settings for patient with COPD of a single lung and a history of pneumonectomy.
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肺切除术后患者长期呼吸支持的有效性
呼吸支持治疗慢性呼吸衰竭的最后阶段已被广泛应用,其中最常见的是慢性阻塞性肺病晚期患者。事实证明,慢性高碳酸血症呼吸衰竭的发生与病情加重、住院率增加以及随后出现失代偿的时间加快有关。此外,高碳酸血症也是死亡率的一个决定性因素。治疗高碳酸血症的有效方法是无创通气。长期无创通气可改善日间高碳酸血症,提高生活质量,延长慢性阻塞性肺疾病患者下一次严重恶化前的生存期。慢性阻塞性肺病患者有不同的表型和各种并发症,这可能对呼吸支持方法的选择和治疗效果的评估带来挑战。目前还缺乏有关慢性阻塞性肺病患者在肺切除术后长期接受无创呼吸支持治疗的数据。大多数出版物都是针对肺切除术后的早期阶段。本刊物旨在介绍一例成功为慢性阻塞性肺疾病和单肺支气管扩张患者实施长期无创通气联合氧疗的病例。文中反映了低氧血症和随后发展的高碳酸血症慢性呼吸衰竭的管理阶段。我们展示了对一名因慢性阻塞性肺病和肺切除术导致慢性高碳酸血症呼吸衰竭的患者进行长期非卧床无创通气的成功经验。观察研究表明,在门诊环境下为单肺慢性阻塞性肺病和有肺切除病史的患者提供联合呼吸支持是可行的。
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