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相關文獻
- Risk Factors of Extubation Failure in Extremely Low Birth Weight Infants: A Five Year Retrospective Analysis
- Risk Factors for Reintubation in Ventilator-Dependent Patients
- 非侵入性正壓呼吸器對拔管失敗之影響
- 計畫性拔管失敗之衝擊及其臨床處置
- The Role of the Cuff Leak Test in Predicting the Effects of Corticosteroid Treatment on Postextubation Stridor
- 拔管成功之預測 (Effective Predictors of Extubation Success)
- Factors Affecting Cuff Leak Test Results of Adult Patients under Mechanical Ventilation
頁籤選單縮合
題名 | Risk Factors of Extubation Failure in Extremely Low Birth Weight Infants: A Five Year Retrospective Analysis=超低體重早產兒拔管失敗的五年回顧分析 |
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作者 | 李昭儀; 蘇百弘; 林宗文; 林鴻志; 李采娟; 王乃弘; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷期 | 43:6 民91.11-12 |
頁次 | 頁319-325+370 |
分類號 | 417.5171 |
關鍵詞 | 超小早產兒; 拔管失敗; 拔管後肺部塌陷; Extremely low birth weight infant; Extubation failure; |
語文 | 英文(English) |
中文摘要 | 從1997年1月至2001年12月五年期間,中國醫藥學院附設醫院新生兒加護病房共有29位小於1000公克的超小早産兒因拔管失敗者來作一回溯性的研究。拔管失敗率爲21%(29/138)。其中14位(49%)因爲嚴重呼吸暫停而再行插管,11位(39%)因爲拔管後肺部塌陷引發呼吸衰竭而插管,2位(6%)因嚴重肺病變,1位(3%)因肺出血,1位(3%)因肋膜積水導致拔管失敗。拔管失敗的超早産兒有較高比例的慢性肺病變,院內呼吸道感染,及後肺部塌陷。院內呼吸道感染引發的肺炎以格蘭氏陰性菌爲主。這個研究顯示,預防及減少院內呼吸道感染及拔管後肺部塌陷的是超早産兒拔管成功的當前要務,減少因呼吸再行插管的機率,是超小早産兒拔管成功的一項重要因素。 |
英文摘要 | Extubation failure is one of the most serious complications in extremely low birth weight infants (ELBWI) on mechanical ventilation tberapy. We performed a 5-year retrospective analysis to realize the status of extubation failure in ELBWI. Extubation failure was defined as requirements of re-intubation within 72 hours after extubation. The extubation failure rate was 21% (29/138). The mean birth body weight was 808.3±140.4 gm. The mean gestational age was 25.8±1.2 wks. The incidence of chronic lung disease (CLD) in infants with extubation failure was 100% (29/29). Apnea of prematurity 49% (14/29) and post-extubation atelectasis 39% (11/29) were the most common reasons for reintubation. The major microbiology findings which correlated with nosocomial pneumonia in infants with extubation failure were Acinetobacter baumanni (21%), Klebsiella pneumonia (21%), Pseudomonas aeroginosa (14%), and Methicillin resistent staphylococcus aureus (14%). In conclusion, post-extubation atelectasis and apnea were the most common reasons for reintubation. ELBWI with extubation failure had higher incidences of post-extubation atelectasis, CLD, and nosocomial pneumonia. Further prospective studies are needed in order to clarify the appropriate extubation program for ELBWI and to prevent postextubation atelectasis and nosocomial pneumonia. |
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