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題 名 | Adrenal Insufficiency Is Associated with Difficult Ventilator Weaning and Increased In-Hospital Mortality in Respiratory Care Ward=呼吸照護病房腎上腺功能不全與呼吸器脫離困難及死亡率之相關性探討 |
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作 者 | 連偉立; 陳煌麒; 陳美芳; | 書刊名 | 中華民國重症醫學雜誌 |
卷 期 | 13:2 2012.12[民101.12] |
頁 次 | 頁82-89 |
分類號 | 419.73 |
關鍵詞 | 腎上腺功能不全; 呼吸器脫離; 呼吸照護病房; 死亡率; Adrenal insufficiency; Ventilator weaning; Respiratory care ward; In-hospital mortality; |
語 文 | 英文(English) |
中文摘要 | 背景與目的:腎上腺功能不全是重症個案常見的一種障礙,常常會增加個案呼吸器脫離困難與死亡率。然而,在呼吸照護病房卻鮮少探討,故本研究目的為探討呼吸照護病房呼吸器依賴病患之腎上腺功能不全與呼吸器脫離困難及死亡率之相關性。 方法:採回朔性研究法,從 2008年 9月 1日至 2009年 11月 30日,個案已使用呼吸器超過 21天為研究對象,共 48名個案參與本研究。其中 19名個案 cortisol ≧ 25 μg/dl, 29名個案 cortisol < 25 μg/dl。 結果:在死亡率方面,在 cortisol < 25 μg/dl 那組顯著高於 cortisol ≧ 25 μg/dl那組 (44.8% vs. 21.1%, P=0.042)。在住院後至死亡的天數方面, cortisol < 25μg/dl 那組顯著短於 cortisol ≧ 25 μg/dl那組 (146.92±65.83 vs. 215.0±53.37, P=0.039)。在能呼吸器脫離的百分比, cortisol ≧ 25 μg/dl那組高於 cortisol < 25 μg/dl 那組。然而,在呼吸器脫離天數方面, cortisol ≧ 25 μg/dl與 cortisol < 25 μg/dl兩組間無顯著差異 (P=0.284)。 結論:在呼吸照護病房,對呼吸器依賴延長的個案,腎上腺功能不全有較高的死亡率。然而成功呼吸器的脫離天數與腎上腺功能不全無顯著相關,可能是高的死亡率導致較低的脫離百分比。 |
英文摘要 | Background and objective: Adrenal insufficiency (AI) is a common disorder in critical ill patients and usually increases difficult ventilator weaning and mortality. However, it is seldom discussed with regards to patients with prolonged mechanical ventilation in respiratory care wards (RCW). The purpose of this study is to examine relationship of adrenal insufficiency, difficult ventilator weaning and in-hospital mortality among patients in RCW. methods: We retrospectively collected 102 patients in RCW from September 1, 2008 to November 30, 2009. 48 patients enrolled in the study were under mechanical ventilation for more than 21 days. 19 patients with cortisol ≧25 μg/dl and 29 patients with cortisol < 25 μg/dl were enrolled in the study. results: In-hospital mortality was higher in the group of cortisol < 25 μg/dl than the group of cortisol ≧25 μg/dl (44.8% vs. 21.1%, P=0.042). The days of in-hospital mortality after admission were found to be shorter in the group of cortisol < 25 μg/dl than the group of cortisol ≧25 μg/dl (146.92±65.83 vs. 215.0±53.37, P=0.039). The weaning percentage was higher in the group of cortisol ≧25 μg/dl than the group of cortisol < 25 μg/dl (57.9% vs. 31.0%, P=0.036). However, the weaning days between the two groups were shown to be of no statistical significance (P=0.284). conclusions: For patients with prolonged mechanical ventilator dependence, AI may be an important risk factor which may associate with a higher in-hospital mortality in RCW. Although the successful weaning days were not associated with AI, higher in-hospital mortality among AI patients might lead to a lower weaning percentage. |
本系統中英文摘要資訊取自各篇刊載內容。