The minute ventilation recovery time used as a predictor of weaning in patients with chronic obstructive pulmonary disease
10.3760/cma.j.issn.1671-0282.2014.01.021
- VernacularTitle:分钟通气量恢复时间在慢性阻塞性肺疾病患者撤机中的作用
- Author:
Yijie ZHANG
;
Yingying LU
;
Zhong ZHANG
;
Jun WU
;
Xinghui YANG
;
Guoyan YAO
;
Xiuhong NIE
- Publication Type:Journal Article
- Keywords:
chronic obstructive pulmonary disease;
weaning;
minute ventilation recovery time
- From:
Chinese Journal of Emergency Medicine
2014;23(1):89-92
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of minute ventilation recovery time (VERT) as a weaning predictor in mechanically ventilated patients with chronic obstructive pulmonary disease (COPD).Methods A prospective study was performed from March 2008 to July 2012.Fifty-two COPD patients under mechanical ventilation for more than 48 hours in our RICU tolerated a spontaneous breathing trial (SBT) and were ready for planned extubation.After SBT,these patients were placed back on their pre-SBT ventilator settings for up to 25 minutes,during which VERT was obtained.VERT was defined as the time for minute ventilation to return to baseline measured before SBT.Respiratory rate,tidal volume,minute ventilation and respiratory rate/tidal volume ratio were also obtained before SBT and just after SBT.Arterial blood gas data were measured and recorded before weaning.According to the weaning outcome,the patients were classified as successful group (40 cases) or failed group (12 cases).VERT and other quantitative variables were compared using t test.A multiple logistic regression was performed to explore possible factors associated with the weaning outcome.The sensitivity and specificity of VERT for predictive capacity in weaning were assessed using ROC cure.Results VERT and respiratory rate after SBT were significantly different between two groups.Multiple logistic regression revealed that VERT was the only predictor associated with weaning outcome (b =0.282,P ＜0.001).The area under ROC curve for VERT was 0.957 (95％ CI:O.907-1.008).With a cut-off value of 10.5 minutes,the sensitivity and specificity of VERT for predicting weaning failure were 1.0 and 0.85,respectively.Conclusions VERT may be a new predictor for extubation and determination of mechanical ventilation weaning in patients with COPD.VERT is a variable to be easily measured thereby being conveniently used in clinical practice.
