title: The optimum timing to wean invasive ventilation for patients with AECOPD or COPD with pulmonary infection.
abstract: COPD is characterized by a progressive decline in lung function and mental and physical comorbidities. It is a significant burden worldwide due to its growing prevalence, comorbidities, and mortality. Complication by bronchial-pulmonary infection causes 50%-90% of acute exacerbations of COPD (AECOPD), which may lead to the aggregation of COPD symptoms and the development of acute respiratory failure. Non-invasive or invasive ventilation (IV) is usually implemented to treat acute respiratory failure. However, ventilatory support (mainly IV) should be discarded as soon as possible to prevent the onset of time-dependent complications. To withdraw IV, an optimum timing has to be selected based on weaning assessment and spontaneous breathing trial or replacement of IV by non-IV at pulmonary infection control window. The former method is more suitable for patients with AECOPD without significant bronchial-pulmonary infection while the latter method is more suitable for patients with AECOPD with acute significant bronchial-pulmonary infection.
authors.affiliation: Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Yuanlin
authors.initials: Y
authors.lastname: Song
authors.affiliation: Guangzhou Institute of Respiratory Disease, Guangzhou, People's Republic of China.
authors.forename: Rongchang
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing China-Japan Friendship Hospital, Beijing, People's Republic of China.
authors.forename: Qingyuan
authors.initials: Q
authors.lastname: Zhan
authors.affiliation: Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Shujing
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Pulmonary Medicine, Chaoyang Hospital, Beijing, People's Republic of China.
authors.forename: Zujin
authors.initials: Z
authors.lastname: Luo
authors.affiliation: Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Jiaxian
authors.initials: J
authors.lastname: Ou
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing China-Japan Friendship Hospital, Beijing, People's Republic of China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
mesh_terms: D000208:Acute Disease; D018450:Disease Progression; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000628:therapy*; D012141:Respiratory Tract Infections / Q000150:complications*; D013997:Time Factors; D015300:Ventilator Weaning / Q000592:standards*
keywords: chronic obstructive pulmonary disease; mechanical ventilation; pulmonary control window; spontaneous breathing trial; weaning