Influencing factors of the ventilator weaning outcome in patients undergoing mechanical ventilation after surgery
10.3760/cma.j.issn.1008-6706.2020.24.009
- VernacularTitle:手术后机械通气患者撤机结局的影响因素分析
- Author:
Yasheng ZHAN
1
;
Jun ZHANG
Author Information
1. 浙江省，金华市人民医院重症医学科 321021
- From:
Chinese Journal of Primary Medicine and Pharmacy
2020;27(24):2982-2985
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the influence factors of ventilator weaning outcome in patients undergoing mechanical ventilation after surgery.Methods:The clinical data of 87 patients undergone postoperative mechanical ventilation and admitted to Intensive Care Unit(ICU) in Jinhua People's Hospital from January 1, 2017 to July 31, 2018 were retrospectively analyzed.The patients were divided into successful group (57 cases) and failure group (30 cases) according to the weaning outcome.The basic clinical data of the patients were collected, including gender, age, whether they had underlying disease or not and whether it was emergency operation or not.The levels of albumin(ALB), white blood cells(WBC), hemoglobin(HB), platelets(Plt), oxygen partial pressure(PaO 2), carbon dioxide partial pressure (PaCO 2), oxygenation index(OI), lactate(Lac) and mechanical ventilation time(T) of the patients within 24h of ICU admission after operation were recorded, and the acute physiology and chronic health evaluation scoring systemⅡ(APACHEⅡ) score worst value score of the patients within 24h of ICU admission was calculated.The risk factors affecting the weaning outcome after operation were analyzed using univariate analysis and logistic regression analysis. Results:The creatinine, APACHEⅡ score, Lac, PaCO 2 in the successful group were 66.60mol/L, (21.67±4.67)points, 2.60mmol/L, 34.50mmHg, respectively, which in the failure group were 79.00mol/L, (25.73±4.27) points, 5.00mmol/L, 37.80mmHg, respectively, and the differences between the two groups were statistically significant ( t=2.224, 3.975, 2.609, 2.001, P=0.026, <0.001, 0.009, 0.045). The single factor analysis showed that the ventilator weaning outcome in patients undergoing mechanical ventilation after surgery was related with creatinine, APACHEⅡ score, Lac, PaCO 2.Logistic regression analysis showed that the APACHE Ⅱ grade B value was 0.174, Wald value of 6.845, P=0.009<0.05, suggested that APACHEⅡ score was the independent risk factor for surgery patients withdraw machine failure.Draw the APACHEⅡ score ROC curve, the area under the curve was 0.734, the curve of cut-off point was 22.95, the corresponding sensitivity and specificity were 59.60% and 73.30% respectively. Conclusion:APACHEⅡ score is an independent risk factor affecting postoperative weaning outcome, it can help to predict the weaning outcome of patients undergoing mechanical ventilation after surgery, but its sensitivity is not high.
