断奶
医学
机械通风
入射(几何)
重症监护室
逻辑回归
队列
队列研究
前瞻性队列研究
儿科
重症监护医学
急诊医学
外科
内科学
光学
物理
作者
GC Funk,S. Anders,Breyer Mk,Otto Chris Burghuber,G Edelmann,Werner Heindl,G Hinterholzer,Robab Kohansal,Ralf Schuster,A Schwarzmaier-D'Assie,Andreas Valentin,Sylvia Hartl
出处
期刊:The European respiratory journal
[European Respiratory Society]
日期:2009-06-18
卷期号:35 (1): 88-94
被引量:216
标识
DOI:10.1183/09031936.00056909
摘要
Weaning from mechanical ventilation was categorised as simple, difficult or prolonged by an international task force of the American Thoracic Society/European Respiratory Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine/Sociéte de Réanimation de Langue Française in 2007. This new classification has not been tested in clinical practice. The objective of the present study was to determine the incidence and outcome of weaning according to the new categories. We included medical and surgical patients who required mechanical ventilation in a prospective, multicentre, 6-month cohort study. From an initial cohort of 510 patients, 257 intubated patients started weaning. Of these patients, the cumulative incidences of simple, difficult, and prolonged weaning were 152 (59%), 68 (26%) and 37 (14%), respectively. Hospital mortality was increased in patients with prolonged (32%) but not difficult (9%) weaning in comparison with those with simple weaning (13%), overall p = 0.0205. In a multivariate logistic regression model, prolonged but not difficult weaning was associated with an increased risk of death. Ventilator-free days and intensive care unit (ICU)-free days were decreased in both difficult and prolonged weaning. In conclusion, the new weaning category prolonged weaning is associated with increased mortality and morbidity in the ICU. The new category difficult to wean was associated with increased morbidity, but not mortality.
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