Ventilator-dependent patients with COPD

Figure 8 Continuous recordings of airflow (Flow) and esophageal pressure (Pes) in a long-term ventilator-dependent patient with COPD during a brief period of unassisted breathing. Arrows indicate ineffective inspiratory efforts—inspiratory efforts not associated with inspiratory flow. In one study (41), ineffective inspiratory efforts were recorded in 40% of long-term ventilator-dependent patients with COPD but not in patients with COPD who were successfully weaned after a period of prolonged ventilatory support. Abbreviations Pes, esophageal pressure COPD, chronic obstructive pulmonary disease. Source From Ref. 41.

Ventilator-dependent patients and those with stable COPD often have respiratory acidosis. A balanced mixture of chloride and acetate salts often is appropriate in these patients. The acid-base status of the ICU patient with pulmonary compromise should be monitored daily, whereas every 2 to 3 days may be adequate for the stable COPD patient. 

---