Application of modified spontaneous breathing trail in weaning for elderly ventilated patients with chronic obstructive pulmonary disease
10.3969/j.issn.1006-5725.2015.13.019
- VernacularTitle:改良的自主呼吸实验在机械通气的老年慢性阻塞性肺疾病患者撤机过程中的应用
- Author:
Xiaoqing LIU
;
Yimin LI
;
Weiqun HE
;
Sibei CHEN
;
Lingbo NONG
;
Ling SANG
- Publication Type:Journal Article
- Keywords:
Spontaneous breathing trail;
Older;
Chronic obstructive pulmonary disease;
Mechanical Ventilation;
Weaning
- From:
The Journal of Practical Medicine
2015;(13):2130-2133
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of the modified spontaneous breathing trail (SBT) on the weaning procedure for elderly ventilated patients with chronic obstructive pulmonary disease (COPD). Methods Ventilated acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients ready for SBT from January 2013 to November 2014 were enrolled and were divided into 2-hour SBT (conventional SBT) group and 6-hour SBT (modified SBT) group randomly. The following factors were recorded and analyzed: age, gender, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ)score before SBT, mechanical ventilation time before SBT, the oxygenation index before SBT, rapid shallow breathing index (RSBI), maximum inspiratory pressure (MIP), the outcome of SBT and weaning, the ICU mortality and the length of stay in ICU. Results Forty-one cases were enrolled with 20 cases in 2-hour SBT group and 21 cases in 6-hour SBT group. Patients′age, gender, APACHE Ⅱ score before SBT, mechanical ventilation time before SBT, the oxygenation index before SBT, RSBI and MIP indicated no significant difference in two groups (P > 0.05). There was a significantly higher SBT successful rate (90.0%) in 2-hour SBT group than that in 6-hour SBT group (57.1%)(P = 0.018), but patients passing SBT successfully in 2-hour SBT group showed a significant lower weaning successful rate (72.2%) than those in 6-hour SBT group (100.0%)(P = 0.046). No significant difference was found in ICU morality and the length of stay in ICU in two groups (P > 0.05). Conclusions For elderly ventilated COPD patients , a modified SBT may serve as a useful procedure to predict weaning outcome which will increase the ICU mortality and the time of stay in ICU.
