Predictive value of quantitative CT lung density in tracheal intubation of the patients with acute exacerbation of chronic obstructive pulmonary disease
Fan Jifang
Zhang Zhenle
Huang Weiqing
Liang Qing
Zeng Liangbo
Wang Xida
Zhang Xianliang
Chen Huai
Liu Yun
Abstract：Objective To investigate the predictive value of quantitative CT lung density in tracheal intubation of the patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A retrospective analysis was conducted on a total of 78 AECOPD patients admitted to the Emergency Department of the First Affiliated Hospital of Guangzhou Medical University from January 2019 to December 2023.Patients were divided into the control group(non-invasive ventilator-assisted ventilation,n=50)and the study group(tracheal intubation-assisted ventilation,n=28)based on different mechanical ventilation methods during hospitalization.Afterward,general data,laboratory tests and quantitative CT lung density parameters were collected and analyzed between the two groups.Moreover,the influence of different factors on the outcome of tracheal intubation was investigated by the multivariate Logistic regression analysis.Finally,the predictive value of quantitative CT lung density parameters in the outcome of tracheal intubation was analyzed by using the receiver operating characteristic(ROC)curve.Results Compared with the control group,the study group had a higher procalcitonin(PCT),the percentage of hypoventilation lung tissue,non-aerated lung tissue and damaged lung tissue and a lower arterial partial pressure of carbon dioxide(PaCO2)and PaO2/FiO2,and the differences were statistically significant(P＜0.05).Meanwhile,multivariate Logistic regression analysis revealed that damaged lung tissue[OR(95％CI)=1.207(1.030-1.415)]was a risk factor for tracheal intubation in AECOPD(P＜0.05).Additionally,Spearman correlation analysis showed that damaged lung tissue was negatively correlated with PaO2/FiO2(r,=-0.516,P＜0.001).Furthermore,ROC curve analysis showed that damaged lung tissue(AUC=0.705)provided a significantly predictive value for tracheal intubation in AECOPD patients(P＜0.05),with a cut-off value of 11.5％.Conclusions Damaged lung tissue can predict tracheal intubation in AECOPD patients and assist in the early identification of critical patients.
Keywords：Acute exacerbation of chronic obstructive pulmonary diseaseLung densityTracheal intubationNon-invasive ventilationDamaged lung tissue
Publication Date：2024-09-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 796-800 )