Left ventricular function during weaning of patients with chronic obstructive pulmonary disease

Intensive Care Med. 1994;20(3):181-6. doi: 10.1007/BF01704697.


Objective: Determine the evolution of left ventricular ejection fraction during weaning.

Design: Prospective study.

Setting: Intensive care unit of a university teaching hospital.

Patients and participants: 12 consecutive mechanically ventilated patients, without documented coronary artery disease, suffering from acute exacerbation of chronic obstructive pulmonary disease and able to be weaned.

Measurements and results: Left ventricular ejection fraction was determined during mechanical ventilation, inspiratory pressure support (10 cmH2O) and spontaneous ventilation with constant inspiratory oxygen fraction using technetium 99m radionuclide angiography. Spontaneous ventilation induced a significant decrease in left ventricular ejection fraction from 54.5 +/- 12.4 to 47.0 +/- 13% (p < 0.01). Inspiratory pressure support induced a slight but non-significant decrease in left ventricular ejection fraction from 55.0 +/- 12.1 to 50.3 +/- 12.4%. Left ventricular ejection fraction was homogeneously reduced by spontaneous ventilation without patent regional wall motion abnormalities of the left ventricle. Myocardial 201thallium imaging performed 15 min after weaning showed a normal perfusion in the left ventricle anterior and posterior free wall.

Conclusion: Weaning of patients suffering from chronic obstructive pulmonary disease without coronary artery disease induced a significant reduction in left ventricular ejection fraction. The non significant decrease in left ventricular ejection fraction observed with inspiratory pressure support suggested that our results might be explained by a weaning induced increase in afterload.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Angiocardiography
  • Coronary Angiography
  • Factor Analysis, Statistical
  • Female
  • Forced Expiratory Volume
  • Humans
  • Lung Diseases, Obstructive / diagnosis
  • Lung Diseases, Obstructive / mortality
  • Lung Diseases, Obstructive / physiopathology*
  • Lung Diseases, Obstructive / therapy*
  • Male
  • Middle Aged
  • Myocardial Ischemia / diagnosis
  • Myocardial Ischemia / etiology
  • Myocardial Ischemia / physiopathology
  • Prospective Studies
  • Stroke Volume
  • Survival Rate
  • Technetium Compounds
  • Thallium Radioisotopes
  • Ventilator Weaning* / adverse effects
  • Ventricular Function, Left*
  • Vital Capacity


  • Technetium Compounds
  • Thallium Radioisotopes