open access

Vol 14, No 2 (2020)
Case report
Published online: 2020-05-16
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Advanced COPD in a patient treated in the Intensive Care Unit

Urszula Kościuczuk, Ewa Tałałaj, Piotr Jakubów, Adam Łukasiewicz
DOI: 10.5603/PMPI.2020.0013
·
Palliat Med Pract 2020;14(2):130-134.

open access

Vol 14, No 2 (2020)
Case report
Published online: 2020-05-16

Abstract

Chronic obstructive pulmonary disease (COPD) is the 3rd leading cause of death worldwide and 7th in
the classification of years of life lost or lived with disability. Indeed, COPD prevalence is still increasing.
Moreover, chronic respiratory failure in advanced COPD is one of the most common indications for palliative
care. The deterioration of general health, including respiratory failure, raises many doubts as to the
need for hospitalization, prognosis and medical interventions. The decision to start palliative care provision
in COPD patients is based on poor prognosis, but it is not clear when it should be started. Proper
and specialized palliative care in this patient population can limit hospital, Intensive Care Unit (ICU), and
emergency admissions.
A case of a patient with advanced COPD receiving palliative care and the treatment in the ICU is presented.
Due to pneumonia with permanent respiratory hypercapnia, the patient was hospitalized and qualified to
tracheostomy and invasive ventilation. In bronchofiberoscopy granulation tissue narrowing the airways
below the tracheotomy tube, confirmed by the CT scan. The patient was qualified for rigid bronchofiberoscopy
to widen the trachea. Antibiotic therapy with multidirectional pharmacological treatment was
provided at the ICU. The patient was discharged home in a fairly good general condition, on his breathing
with passive oxygen therapy, periodically requiring assisted mechanical ventilation, without carbon dioxide
retention, and with effective cough reflexes. Mechanical causes of respiratory failure in ventilated advanced
COPD patients should be considered. Short–time-intensive therapy treatment may improve the general
condition of ventilated advanced COPD patients.

Abstract

Chronic obstructive pulmonary disease (COPD) is the 3rd leading cause of death worldwide and 7th in
the classification of years of life lost or lived with disability. Indeed, COPD prevalence is still increasing.
Moreover, chronic respiratory failure in advanced COPD is one of the most common indications for palliative
care. The deterioration of general health, including respiratory failure, raises many doubts as to the
need for hospitalization, prognosis and medical interventions. The decision to start palliative care provision
in COPD patients is based on poor prognosis, but it is not clear when it should be started. Proper
and specialized palliative care in this patient population can limit hospital, Intensive Care Unit (ICU), and
emergency admissions.
A case of a patient with advanced COPD receiving palliative care and the treatment in the ICU is presented.
Due to pneumonia with permanent respiratory hypercapnia, the patient was hospitalized and qualified to
tracheostomy and invasive ventilation. In bronchofiberoscopy granulation tissue narrowing the airways
below the tracheotomy tube, confirmed by the CT scan. The patient was qualified for rigid bronchofiberoscopy
to widen the trachea. Antibiotic therapy with multidirectional pharmacological treatment was
provided at the ICU. The patient was discharged home in a fairly good general condition, on his breathing
with passive oxygen therapy, periodically requiring assisted mechanical ventilation, without carbon dioxide
retention, and with effective cough reflexes. Mechanical causes of respiratory failure in ventilated advanced
COPD patients should be considered. Short–time-intensive therapy treatment may improve the general
condition of ventilated advanced COPD patients.

Get Citation

Keywords

Chronic Obstructive Pulmonary Disease (COPD), Intensive Care Unit (ICU), non-invasive ventilation (NIV), palliative care, respiratory failure

About this article
Title

Advanced COPD in a patient treated in the Intensive Care Unit

Journal

Palliative Medicine in Practice

Issue

Vol 14, No 2 (2020)

Pages

130-134

Published online

2020-05-16

DOI

10.5603/PMPI.2020.0013

Bibliographic record

Palliat Med Pract 2020;14(2):130-134.

Keywords

Chronic Obstructive Pulmonary Disease (COPD)
Intensive Care Unit (ICU)
non-invasive ventilation (NIV)
palliative care
respiratory failure

Authors

Urszula Kościuczuk
Ewa Tałałaj
Piotr Jakubów
Adam Łukasiewicz

References (15)
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  15. Wytyczne Polskiego Towarzystwa Anestezjologii i Intensywnej Terapii określające zasady kwalifikacji oraz kryteria przyjęcia chorych do Oddziałów Anestezjologii i Intensywnej Terapii. http://www.anestezjologia.org.pl/.

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