在机械通风和断奶过程中测量的氧化指数的预测值. 一个回顾性队列研究
Esra Eriş1, Ayshan Mammadova2, Ayşe Taşçı Kara3
1Critical Care Fellowship Program, Gazi University School of Medicine, Ankara. e.kurtulgu@gmail.com.
使用动脉氧 (PaO2) 计算的ROX指数比使用SpO2或SaO2.2更好地预测机械通风断奶成功和输出失败. 这有助于评估患者对断奶的准备程度,并预测结果.
科学领域:
- 临界护理医学 临界护理医学
- 呼吸系统生理学 呼吸系统生理学
- 肺部病理学 肺部病理学
背景情况:
- 评估机械通风 (MV) 准备,断奶和预测输出管成功在重症监护中至关重要.
- 氧和率 (ROX) 指数用于评估断奶参数,但其计算方法各不相同.
- 使用不同氧和度 (PaO2,SaO2%,SpO2%) 的ROX指数计算进行比较对于优化其预测值至关重要.
研究的目的:
- 调查ROX指数在评估断奶准备和成功中的预测价值.
- 为了比较使用部分动脉氧气压 (PaO2),动脉氧和 (SaO2%) 和外周氧和 (SpO2%) 的ROX指数计算的有效性.
- 确定ROX指数能够预测自发呼吸试验 (SBT) 的成功,输出失败 (EF) 和死亡率的能力.
主要方法:
- 一个回顾性队列研究,涉及107名机械呼吸患者.
- 每天使用公式 (PaO2或SaO2或SpO2 /FiO2) /呼吸速率在MV和断奶期间计算ROX指数.
- 记录了积极的终端呼气压和峰值呼气压;分析了ROX值以预测断奶准备,SBT,EF和死亡率.
主要成果:
- 在MV和SBT期间使用PaO2计算的ROX值显示,与SaO2和SpO2相比,对断奶准备,EF和死亡率的预测优越.
- 在MV的第三天用PaO2计算的ROX指数显示了预测EF (ROX<11) 的最高灵敏度 (81%) 和特异性 (70%).
- 在107名患者中,64人有资格断奶,44人成功地进行了输出管,而19人经历了输出管失败.
结论:
- 除了SPO2%和SaO2%外,使用动脉血气PaO2值计算ROX指数,可以提高断奶准备,SBT成功和死亡率的预测.
- 从PaO2获得的ROX指数似乎是一个比从SpO2或SaO2.2获得的更强大的预测器.
- 需要进一步的大规模研究来验证和标准化使用不同氧和度的ROX指数.
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