Title: Effective secretolytic and bronchodilatativ Strategies by Prolonged Weaning by COPD GOLD D Patients on Respiratory Intensive Care Unit after quantitative based Lung Computertomographie and Lung Volume Reduction Surgery bei massive Emphysema

Abstract:

A meta-analysis of studies published in the 1990s calculated the incidence of VAP (ventilator-associated pneumonia), which is equivalent to 16.5 cases per 1,000 patient days. Attributable mortality due to VAP was estimated to be 20-40%, although the range in different studies was very broad. Healthcare costs related to VAP seem to be remarkable in particular with regard to multidrug-resistant pathogens. VAP is an infection frequently caused by Pseudomonas aeruginosa, Haemophilus spp., and Klebsiella spp. or by Staphylococcus aureus. Anaerobes are a rare cause of VAP. Patients with COPD GOLD D and massive Emphysema, who undergo a Lung Volume Reduction Surgery by prolonged Weaning and long-term treatment on intensive care units, after a quantitative-based Lung Computertomographie to prevent VIDD need an intensive and efficient secrtlytic additionally to bronchoscopy by presenting bronchospasms at the same time. On our Respiratory Intensive Care Unit, we use a Dymedso Frequenzer with sound wave (45 Hz) from the company inspiration medical four times daily in combination with six times deeply bronchodilatativ Aeronep Inhalation from the company Aerogen to reach a 17% lung disposition in compared to 3% by conventional nebulizer. We optimize this by an LALMA/LABA fix combination (Glycopyrroniumbromid/Formoterol) via tracheal cannula from the company AstraZeneca with AEROSPHERE Delivery Technology. Active ingredient particles are connected on aerodynamic Phospholipid particles, which are a natural carrier substance and a component of lung surfactant. Previous studies with health persons could show lung disposition of 38%. The safety and efficiency were demonstrated in phase 3 study PINNACLE 1 and 2 and long-term data of safety and effectiveness in PINNACLE 3.

Biography:

M Lavae-Mokhtari is a consultant in the Respiratory Intensive Care Unit in General Hospital Ibbenburen in Germany since 2013. He has seven publications, 17 national and international poster publications, one book publication, and three scientific international and one national oral presentation. He has 152 citations and a 17.48 RG Score by research gate. He is a member of the German Respiratory Society, Section Intensive-Care and Ventilation Medicine, European Respiratory Society, Section Intensive-Care and Ventilation Medicine, and Section Thorax oncology and German Interdisciplinary Society of Outpatient Ventilation.