الفهرس 
Chronic Obstructive Pulmonary DiseaseOnly 14 pages are availabe for public view
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Abstract
Despite of the several techniques that had been developed to facilitate discontinuation of MV, weaning remains a great challenge for the physician and the method by which it is accomplished remains controversial among critical-care practitioners particularly in difficult-to-wean patients such as those with chronic obstructive pulmonary disease (COPD).
The aim of this thesis was to compare the outcome of weaning by pressure support, and IMT in difficult weaning in mechanically ventilated chronic obstructed pulmonary disease patients with respiratory failure. It was found that there is statistical significant difference between the two groups regarding weaning outcome.
The present study was conducted on 40 COPD patients admitted to the intensive care Abasia chest hospital with ARF and required MV. In the current study, the 1st group (A) of (20) COPD patients difficult to wean due to respiratory muscle weakness and MIP below -20 cm/H2o selected for training by adjustment of ventilator sensitivity method while the 2nd group(B) of (20) COPD patients difficult to wean due to respiratory muscle weakness and MIP below -20 cm/H2o were also selected to be weaned by the (PSV) mode,.
In this study, there was no statistically significant difference between the two groups regarding age, sex, blood gas (ABGs). RR TV AND MIP before weaning .but, there was statistically significant difference between the tow groups regarding duration on MV, duration in hospital and duration in ICU.
Also, there was highly significant difference between successful and failure group as regards blood gases and lung mechanics.
This study shows that the secondary outcome data were all statistically significant in favor of IMT group and also were matching to result of previous studies done on the same parameters.
IMT improve respiratory muscle performance and facilitate weaning in COPD mechanically ventilated patients especially those difficult weaning.
Weaning failure resulting in prolonged ventilation is detrimental to the individual as it is associated with increased risk of respiratory muscle weakness, for that we suggest Training of respiratory muscle for mechanically ventilated patients those difficult weaning
.