[将呼吸生理功作为机械通气患者撤机参数的临床研究]

[Clinical study of physiologic work of breathing as a weaning parameter in mechanically ventilated patients].

作者信息

Qiu H, Du B, Ma S

机构信息

Department of Critical Care Medicine, Peking Union Medical College Hospital, Beijing 100730.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 1998 Feb;21(2):105-7.

PMID:11263382

Abstract

OBJECTIVE

To evaluate the physiologic work of breathing (WOBphy) as a predicting Parameter of weaning and extubation.

METHODS

WOBphy was obtained by the patient's work of breathing (WOBt), minuting the imposed work of breathing (WOBimp). In weaning trial, if the patients could not meet predefined extubation criteria, but WOBphy < 0.70 J/L, the patients were also extubated immediately.

RESULTS

In a group of 28 patients who met the predefined criteria (group 1), 27 patients were successfully extubated. In another group of 13 patients who could not meet the criteria, but WOBphy < 0.70 J/L (group 2), extubation was successful in 12 patients. WOBt and WOBimp were significantly higher in group 2 (1.37 +/- 0.50 and 0.82 +/- 0.37 J/L) than group 1 (0.96 +/- 0.38 and 0.55 +/- 0.27 J/L, P < 0.05), while WOBphy was higher in group 2, but did not reach statistical significance.

CONCLUSIONS

WOBphy < 0.70 J/L may be safe as the weaning and extubation criterion and enables earlier extubation.

摘要

目的

评估呼吸生理功（WOBphy）作为撤机和拔管预测参数的价值。

方法

通过患者呼吸功（WOBt）获取WOBphy，并记录施加的呼吸功（WOBimp）。在撤机试验中，若患者未达到预设的拔管标准，但WOBphy<0.70J/L，则也立即进行拔管。

结果

在一组28例符合预设标准的患者（第1组）中，27例成功拔管。在另一组13例未达到标准但WOBphy<0.70J/L的患者（第2组）中，12例拔管成功。第2组的WOBt和WOBimp（分别为1.37±0.50和0.82±0.37J/L）显著高于第1组（分别为0.96±0.38和0.55±0.27J/L，P<0.05），而第2组的WOBphy虽较高，但未达到统计学意义。