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[腹部大手术重症患者机械通气撤机相关危险因素分析]

[Analysis of risk factors associated with weaning from mechanical ventilation in critical patients with major abdominal surgery].

作者信息

Li S, An Y Z, Ren J Y, Zhu F X, Chen H

机构信息

Department of Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China.

Department of Cardiology, Peking University People's Hospital, Beijing 100044, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2014 Dec 18;46(6):911-6.

Abstract

OBJECTIVE

To analyze the risk factors involved in the weaning from mechanical ventilation in critical patients who underwent major abdominal surgery.

METHODS

This retrospective study was conducted at Department of Critical Care Medicine in Peking University People's Hospital. The subjects included all critical ill patients who underwent major abdominal surgery from January 2011 to December 2013. Clinical and laboratory parameters in perioperative period were investigated for the risk factors involved in the weaning from mechanical ventilation.

RESULTS

In this study, 381 patients were included, of whom, 274 were successfully weaned. We found old age, lower left ventricular ejection fraction (LVEF) before surgery, with the complication of myocardial injury after noncardiac surgery (MINS) and lower serum albumin level after surgery were the independent risk factors of weaning from mechanical ventilation. And the days of intensive care unit and 28-day mortality of patients who successfully weaned were better than patients who failed to wean.

CONCLUSION

Old age, lower LVEF before surgery, with the complication of MINS and lower serum albumin level after surgery were independent risk factors of weaning in critical patients who underwent major abdominal surgery.

摘要

目的

分析接受腹部大手术的重症患者机械通气撤机的相关危险因素。

方法

本回顾性研究在北京大学人民医院重症医学科进行。研究对象包括2011年1月至2013年12月期间接受腹部大手术的所有重症患者。对围手术期的临床和实验室参数进行调查,以寻找机械通气撤机的相关危险因素。

结果

本研究共纳入381例患者,其中274例成功撤机。我们发现,高龄、术前左心室射血分数(LVEF)较低、非心脏手术后发生心肌损伤并发症(MINS)以及术后血清白蛋白水平较低是机械通气撤机的独立危险因素。成功撤机患者的重症监护病房住院天数和28天死亡率均优于撤机失败的患者。

结论

高龄、术前LVEF较低、发生MINS并发症以及术后血清白蛋白水平较低是接受腹部大手术的重症患者撤机的独立危险因素。

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