长期机械通气患者气管切开术后的拔管

Decannulation following tracheostomy for prolonged mechanical ventilation.

作者信息

O'Connor Heidi H, Kirby Kelly J, Terrin Norma, Hill Nicholas S, White Alexander C

机构信息

Pulmonary and Sleep Division, New England Sinai Hospital, Stoughton, MA 02072, USA.

出版信息

J Intensive Care Med. 2009 May-Jun;24(3):187-94. doi: 10.1177/0885066609332701.

DOI:10.1177/0885066609332701

PMID:19282297

Abstract

BACKGROUND

We examined the process of decannulation following tracheostomy in patients transferred to a long-term acute care (LTAC) hospital for weaning from prolonged mechanical ventilation (PMV).

METHODS

A retrospective chart review of 135 patients.

RESULTS

Decannulation was successful in 35% of patients a median of 45 days (IQR, 32-76) following tracheostomy. Patients who failed decannulation had a tracheostomy tube placed earlier (14 days; IQR 11-18 vs. 18 days; IQR 14-30, P=.04) and had a shorter length of stay at the acute facility (20 days; IQR, 16-23 vs. 31 days; IQR 24-45, P=.003) compared with patients who were decannulated. Length of stay and cost of care at the LTAC did not differ with decannulation status. At 3.5 years, 35% (47/135) of all patients and 62% (29/47) of decannulated patients were alive.

CONCLUSIONS

Decannulation was achieved in 35% of patients transferred to an LTAC for weaning from prolonged mechanical ventilation.

摘要

背景

我们研究了转至长期急性护理（LTAC）医院以脱离长期机械通气（PMV）的患者气管切开术后的拔管过程。

方法

对135例患者进行回顾性病历审查。

结果

35%的患者在气管切开术后中位45天（四分位间距，32 - 76天）成功拔管。与成功拔管的患者相比，拔管失败的患者气管切开管置入时间更早（14天；四分位间距11 - 18天对18天；四分位间距14 - 30天，P = 0.04），且在急性护理机构的住院时间更短（20天；四分位间距16 - 23天对31天；四分位间距24 - 45天，P = 0.003）。LTAC的住院时间和护理费用与拔管状态无关。在3.5年时，所有患者中有35%（47/135）存活，成功拔管的患者中有62%（29/47）存活。