静态呼吸系统合规性作为急性呼吸系统衰竭患者输出失败的预测指标
Lauren A Abplanalp1,2, Filip Ionescu2,3, Enrique Calvo-Ayala1,2
1Division of Pulmonary and Critical Care, Beaumont Health, Royal Oak, MI, USA.
Lung
|June 10, 2023
概括
静态呼吸系统合规性 (RC) 有效地预测了重症患者的输出失败,超过了快速浅呼吸指数 (RSBI). 这一发现有助于优化呼吸机断奶协议,以获得更好的患者结果.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 机械通风机械通风机械通风
背景情况:
- 客观指数对于预测机械通风患者的输出失败至关重要.
- 目前的协议通常依赖于像快速浅呼吸指数 (RSBI) 这样的指标.
- 静态呼吸系统符合性 (RC) 作为预测因素的实用性尚未完全阐明.
研究的目的:
- 为了调查静态呼吸系统合规性 (RC) 作为输出失败的预测因素.
- 为了将RC的预测性能与快速浅呼吸指数 (RSBI) 进行比较,以便准备排泄.
主要方法:
- 一项跨部门,多机构的研究包括2263名机械呼吸患者.
- 静态呼吸系统合规性 (RC) 和RSBI在输出试验之前被测量.
- 输管失败被定义为需要在72小时内重新输管.
主要成果:
- 静态呼吸系统符合性 (RC) 是24小时 (aOR 1.45) 和72小时 (aOR 1.58) 输出失败的最强预测因素.
- 快速浅呼吸指数 (RSBI) 在任何时间点都没有显示出与输出失败有显著的关联.
- 12.1%的患者需要在72小时内重新输管.
结论:
- 静态呼吸系统符合性 (RC) 是一个有前途的生理标志物,用于风险分层患者的排泄准备.
- 建议在未来的队列中进行进一步的验证研究.
- 与RSBI相比,RC可能会提供更可靠的测定输出管成功.
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