Talakoub Reihanak, Bahrami Mahshid, Honarmand Azim, Abbasi Saeed, Gerami Hamideh
Department of Anesthesiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2017 Apr 25;6:51. doi: 10.4103/2277-9175.205192. eCollection 2017.
No previous study exists to evaluate serum phosphorus (Ph) level as a predictor of the need to mechanical ventilation (MV). This study was designed to determine the predictive ability of admission serum Ph level on MV in patients admitted in Intensive Care Unit (ICU).
This prospective study was conducted on 100 patients (>16 years old), admitted to our ICU over 1-year. Patients were classified into two groups according to the days of the need to MV. Group A: Patients who required equal or <5 days MV, and Group B: Patients who required more than 5 days of MV. We measured total serum Ph concentrations at the times of ICU admission, connecting to the ventilator and weaning from the ventilator.
There were significant differences between serum Ph concentration on admission to ICU (Group A: 3.39 ± 0.39 mg/dl, Group B: 2.89 ± 0.31 mg/dl, < 0.001), at the time of connecting to ventilator (Group A: 2.49 ± 0.38 mg/dl, Group B: 2.25 ± 0.26 mg/dl, = 0.004) and weaning from ventilator (Group A: 3.42 ± 0.33 mg/dl, Group B: 2.98 ± 0.34 mg/dl, < 0.001) between two groups. Duration of ICU stay in Group A was 6.08 ± 1.48 days and in Group B was 15.35 ± 6.45, this difference was significant ( < 0.001). We found the best cut-off point of 3.07 for serum Ph concentration to predict the longer duration of MV.
According to the results of our study, hypophosphatemia may increase the need to MV. Therefore, monitoring serum Ph level is a good prognostic factor to predict the need to ventilation.
此前尚无研究评估血清磷(Ph)水平作为机械通气(MV)需求预测指标的情况。本研究旨在确定重症监护病房(ICU)收治患者入院时血清Ph水平对MV的预测能力。
本前瞻性研究对1年内入住我院ICU的100例患者(年龄>16岁)进行。根据MV需求天数将患者分为两组。A组:需要MV时间等于或<5天的患者;B组:需要MV超过5天的患者。我们在患者入住ICU时、连接呼吸机时以及撤机时测量血清总Ph浓度。
两组患者在入住ICU时(A组:3.39±0.39mg/dl,B组:2.89±0.31mg/dl,P<0.001)、连接呼吸机时(A组:2.49±0.38mg/dl,B组:2.25±0.26mg/dl,P = 0.004)以及撤机时(A组:3.42±0.33mg/dl,B组:2.98±0.34mg/dl,P<0.001)的血清Ph浓度存在显著差异。A组ICU住院时间为6.08±1.48天,B组为15.35±6.45天,差异有统计学意义(P<0.001)。我们发现血清Ph浓度预测MV持续时间较长的最佳截断点为3.07。
根据我们的研究结果,低磷血症可能会增加MV的需求。因此,监测血清Ph水平是预测通气需求的良好预后因素。