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Phlebotomy for rapid weaning and extubation in COPD patient with secondary polycythemia and respiratory failure.
MedLine Citation:
PMID:  20539767     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
The increased incidence of ventilator-associated complications in patients with chronic obstructive pulmonary disease (COPD) necessitates rapid weaning and extubation. The presence of secondary polycythemia in this subgroup increases the incidence of stroke and myocardial infarction due to hyperviscosity and tissue hypoxia. We present a 58-year-old male patient of COPD with secondary polycythemia (hematocrit 64%) who had possible hyperviscosity-related complications leading to cardiac arrest after a minor surgical procedure. The patient developed ventilator dependence after recovery. Phlebotomy was done to remove 10% of total blood volume. Symptomatic improvement was dramatic. Improvement in weaning indices like rapid shallow breathing index and PaO(2)/PAO(2) was observed facilitating rapid weaning and early extubation. Monitored, acute phlebotomy is safe and cost-effective. It decreases blood volume and viscosity, increases cardiac output and improves exercise tolerance in patients.
Authors:
Swagata Tripathy; Sudhansu S Panda; Biswajit Rath
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Lung India : official organ of Indian Chest Society     Volume:  27     ISSN:  0974-598X     ISO Abbreviation:  Lung India     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-06-11     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  8405380     Medline TA:  Lung India     Country:  India    
Other Details:
Languages:  eng     Pagination:  24-6     Citation Subset:  -    
Affiliation:
Department of Kalinga Institute of Medical Sciences, Bhubaneswar, India.
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