Epstein S K
Medical Intensive Care Unit, Pulmonary and Critical Care Division, New England Medical Center, Boston, Massachusetts 02111, USA.
Respir Care Clin N Am. 2000 Jun;6(2):253-301,v-vi. doi: 10.1016/s1078-5337(05)70070-8.
Numerous weaning parameters have been studied over the past three decades. These tests range from easily performed maneuvers such as determining the breathing pattern to complex measurements requiring special equipment such as the mechanical work of breathing. Based on the available evidence, it seems that a negative weaning parameter may not be sufficient justification for delaying weaning trials. Clinicians wishing to use weaning parameters must be aware of the testing methodology and should consider adjusting the thresholds used based on individual patients' characteristics, including the estimated risks of each additional day of mechanical ventilation and the perceived risk of a failed trial of weaning. In a patient repeatedly failing weaning trials, parameters may help elucidate the mechanism for failure thereby providing a target for therapeutic intervention, leading to successful liberation.
在过去三十年里，人们对众多撤机参数进行了研究。这些测试范围广泛，从诸如确定呼吸模式等易于执行的操作，到需要特殊设备（如呼吸机械功）的复杂测量。基于现有证据，似乎撤机参数为阴性可能不足以成为推迟撤机试验的充分理由。希望使用撤机参数的临床医生必须了解测试方法，并且应考虑根据个体患者的特征调整所使用的阈值，包括机械通气每增加一天的估计风险以及撤机试验失败的感知风险。对于反复撤机试验失败的患者，参数可能有助于阐明失败机制，从而为治疗干预提供目标，最终实现成功脱机。
