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Article in Japanese
Abstract
Case Report
Dexmedetomidine facilitates management of noninvasive positive pressure ventilation in agitated patients with acute exacerbation of chronic obstructive pulmonary disease: A case report
Koji Kanemoto Michiko Masuda Kensuke Nakazawa Yousuke Matsuno Hiroaki Iijima Hiroichi Ishikawa
Department of Respiratory Medicine, Tsukuba Medical Center Hospital
ABSTRACT
A 70-year-old man was admitted to our hospital because of acute exacerbation of chronic obstructive pulmonary disease (ax-COPD) with pneumonia and congestive heart failure. He was narcotic, and the arterial blood gas showed acute respiratory acidosis. Noninvasive positive pressure ventilation (NPPV) was initiated; in a while he became agitated and unable to tolerate the NPPV. An administration of dexmedetomidine was started, and he was then sedated without respiratory depression and successfully weaned from the NPPV. The patient's noncooperation as a result of agitation or delirium is a major risk factor of failure because of NPPV, but sedation to such patients has a greater risk for respiratory depression. Dexmedetomidine has less respiratory depressive effect and may be useful as a sedative during NPPV in patients with ax-COPD.
KEYWORDS
Exacerbation of chronic obstructive pulmonary disease Noninvasive positive pressure ventilation Dexmedetomidine Sedation Agitation
Received 8 Mar 2012 ／ Accepted 6 Jun 2012
AJRS, 2(1): 34-38, 2013
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