Heffner J E
Department of Medicine, Medical University of South Carolina, Charleston, USA.
Respir Care Clin N Am. 1998 Sep;4(3):541-59, x.
COPD is a progressive disorder characterized by intermittent episodes of acute exacerbations, each of which has the potential for producing respiratory failure and a need for mechanical ventilation. The decision to intubate a patient with severe underlying COPD requires a blending of the physician's estimation of prognosis with the patient's life goals, values, and self-perceived quality of life. Decisions regarding intubation and life support are aided by initiating a patient-caregiver dialogue during periods of good or stable health before a medical crisis occurs. These discussions can inform patients about the likely outcome of life support and promote meaningful and valid advance directives.
慢性阻塞性肺疾病（COPD）是一种进行性疾病，其特征为急性加重的间歇性发作，每次发作都有可能导致呼吸衰竭并需要机械通气。对于患有严重基础COPD的患者进行插管的决定，需要将医生对预后的评估与患者的生活目标、价值观和自我感知的生活质量相结合。在医疗危机发生之前，在患者健康状况良好或稳定期间启动患者与护理人员的对话，有助于做出关于插管和生命支持的决定。这些讨论可以让患者了解生命支持的可能结果，并促进有意义且有效的预先指示。
