TY - JOUR T1 - Successful prolonged weaning from the respirator after unilateral ELVR treatment with coils JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P3732 AU - Bjoern Schwick Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P3732.abstract N2 - 53 year old Patient with COPD IV was admitted in our hospital with shortness of breath and fever. Patient was treated with NIV plus O2 at home because of CVI. Recently performed lung function test before showed FEV1 of 0,63 L, a VC of 1,1 L and a RV of 5.1 l. Because of hyperkapnia (90 mmhg) and somnolence patient needed invasive ventilation. CT showed leftside pneumonia. High inspiratory and expiratory pressure were used for invasive ventilation and despite of changing ventilation strategies, the patient was getting worse with severe hypercapnia (> 100 mmhg), even after tracheotomy and treatment of pneumonia. Because of capacity problems patient could not be transferred for an extracorporal lung support. Lung volume reduction therapy with 10 coils was performed because of severe hyperinflation, advanced homogenous lung emphysema, ventilation problems, hypercapnia and risk of pneumothorax. After ELVR reduction of ventilation pressure was possible, the patient could be weaned and extubated and was discharged with NIV plus O2. 6 weeks later patient was admitted in our hospital for follow up. 6 M walk test 270 meters with 3 liters of oxygen. CO2 54 mmhg. Nocturnal non invasive ventilation was regulary used. Lung function test after 3 month showed a FEV 1 of 0,7 l,a VC of 0.98 l. Procedure was done after it was impossible to transfer the patient for an extracorporal lung support. We could hardly reduce CO2, so weaning from the ventilator was impossible.This case report showed a successful extubation of a patient with prolonged weaning 3 weeks after ELVR. Life quality was improved, exercise capacity was possible and CO2 level was only slightly elevated after a six weeks follow up. ER -