Chang Min Cheol, Lee Michael Y, Kwak Sang Gyu, Lee Ah Young
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea.
H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA.
Healthcare (Basel). 2025 Jul 31;13(15):1876. doi: 10.3390/healthcare13151876.
This study aimed to identify the risk factors for respiratory failure in patients with intracerebral hemorrhage (ICH) accompanied by intraventricular hemorrhage (IVH) extension. : We retrospectively included 208 patients with ICH accompanied by IVH extension. Respiratory failure was defined as carbon dioxide levels > 45 mmHg with a pH < 7.35 in arterial blood gas analysis (ABGA) or the application of a ventilator due to respiratory dysfunction. We measured the severity of IVH extension using the Graeb scale, and ICH volume was assessed for each patient. : Of the 208 included patients, 83 had respiratory failure. There were no significant differences in age, sex ratio, or Graeb scale score between patients with and without respiratory failure ( > 0.05). However, ICH volume was significantly larger in patients with respiratory failure (42.0 ± 42.5 mL) than in those without (26.4 ± 25.7 mL) ( = 0.003). In the receiver operating characteristic (ROC) curve analysis, the area under the ROC curve for ICH volume predicting respiratory failure was 0.612. The optimal threshold for detecting respiration failure in patients with ICH and IVH dilatation, based on the Youden index, was >63.2 mL, with a sensitivity of 30.12% and a specificity of 89.60%. Approximately 40% of patients experienced respiratory failure following ICH accompanied by IVH extension. : A large ICH volume was associated with the occurrence of respiratory failure. Therefore, caution is required in patients with an ICH volume > 63.2 mL.
本研究旨在确定脑出血（ICH）伴脑室出血（IVH）扩展患者呼吸衰竭的危险因素。我们回顾性纳入了208例ICH伴IVH扩展的患者。呼吸衰竭定义为动脉血气分析（ABGA）中二氧化碳水平>45 mmHg且pH<7.35，或因呼吸功能障碍应用呼吸机。我们使用Graeb量表测量IVH扩展的严重程度，并评估每位患者的ICH体积。在纳入的208例患者中，83例发生呼吸衰竭。有呼吸衰竭和无呼吸衰竭的患者在年龄、性别比或Graeb量表评分方面无显著差异（>0.05）。然而，呼吸衰竭患者的ICH体积（42.0±42.5 mL）显著大于无呼吸衰竭患者（26.4±25.7 mL）（P = 0.003）。在受试者工作特征（ROC）曲线分析中，ICH体积预测呼吸衰竭的ROC曲线下面积为0.612。基于约登指数，检测ICH和IVH扩张患者呼吸衰竭的最佳阈值>63.2 mL，敏感性为30.12%，特异性为89.60%。约40%的ICH伴IVH扩展患者发生呼吸衰竭。大的ICH体积与呼吸衰竭的发生相关。因此，对于ICH体积>63.2 mL的患者需要谨慎。
