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題 名 | Risk Factors and Outcomes of Patients with Prolonged Mechanical Ventilation after Successful Weaning=長期機械通氣病人在成功脫離呼吸器後再放置呼吸器的危險因子及預後 |
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作 者 | 陳泓丞; 林孟志; 林安伸; 王金洲; 王逸熙; | 書刊名 | 胸腔醫學 |
卷 期 | 27:4 2012.08[民101.08] |
頁 次 | 頁209-216 |
分類號 | 415.4 |
關鍵詞 | 長期機械通氣; 再放置呼吸器; Prolonged mechanical ventilation; Reinstitution of ventilator; |
語 文 | 英文(English) |
中文摘要 | 背景及方法:長期機械通氣(PMV)的病人常造成家屬和醫療資源一大負擔。這其中一些病人能成功脫離出院,但也有些人重覆發生呼吸衰竭並再使用呼吸器。本文目的在要找出在成功脫離呼吸器患者中再放置呼吸器的危險因素。高雄長庚紀念醫院呼吸照護中心(RCC)在2006到2007年內有314例成功脫離呼吸器。回顧病歷中的年齡,性別,急性生理及慢性健康評估Ⅱ評分(APACHE II評分),格拉斯哥昏迷評分(GCS),導致急性呼吸衰竭(ARF)原因和脫離呼吸器相關參數,包括呼吸頻率,潮氣量和淺快呼吸指數(RSBI)。研究觀察期從病人入住RCC開始至病人出院為止。結果:314例中有133例(42.4%)因反覆呼吸衰竭再度接受機械通氣。181(57.6%)於出院時無使用機械通氣。這兩組之間在年齡,性別,APACH II評分和相關脫離呼吸參數並沒有顯著差異。脫離呼吸器期間無氣管切開患者(p 值<0.05)則再放置呼吸器的發生率是增加的。17%長期機械通氣(PMV)的病人在住院期間死亡,133 例在接受重置呼吸器患者中有78位(58.7%)在住院期間死亡。結論:病人成功脫離呼吸器的患者中,無接受氣管切開術患者和急性呼吸衰竭原因是充血性心臟衰竭皆是重置呼吸器的危險因素。再放置呼吸器患者的預後是不佳的。 |
英文摘要 | Prolonged mechanical ventilation (PMV) places a large burden on patients, families, and healthcare resources. Some of these patients are successfully weaned and discharged, but some experience recurrent respiratory failure and undergo reinstitution of mechanical ventilation (MV). The purpose of this paper is to identify the risk factors that lead to reinstitution of MV in patients who have undergone successful weaning, and to evaluate their outcome. From January 2006 to December 2007, 314 patients were successfully weaned in the respiratory care center (RCC) of Chang Gang Memorial Hospital. Patients with reinstitution of MV were compared to patients without reinstitution of MV to identify the risk factors that lead to reinstitution. The observation period was from the day of RCC admission to the day of discharge from the hospital. Of the 314 patients, 133 (42.4%) underwent reinstitution of MV due to recurrent respiratory failure, and 181 (57.6%) were discharged without reinstitution. Patients without tracheostomy (p<0.005) had an increased incidence of reinstitution. Seventeen percent of PMV patients expired during RCC admission and 78 (58.7%) of the 133 patients that received reinstitution of MV expired during hospitalization. The incidence of MV reinstitution after successful weaning is increased in patients without tracheostomy and in those with congestive heart failure as the cause of acute respiratory failure. The prognosis of patients with MV reinstitution is poor. |
本系統中英文摘要資訊取自各篇刊載內容。