Michel L, McMichan J C, Marsh H M, Rehder K
J Thorac Cardiovasc Surg. 1979 Nov;78(5):761-4.
The decision to perform tracheal extubation in 44 patients who underwent cardiac operation was based on an assessment of mental alertness, recovery of muscle strength, hemodynamic stability, and adequacy of pulmonary gas exchange. No patients required reintubation. Concomitant measurements of vital capacity (VC) and maximal inspiratory pressure (PImax) were made before a trial of spontaneous ventilation was commenced, after 45 minutes of spontaneous ventilation, and after tracheal extubation. By generally accepted criteria, these measurements suggested the need for continuing mechanical ventilation in 14 patients at the time mechanical ventilatory support was removed and in eight patients at the time of tracheal extubation. In this study, consideration of measurements of VC and PImax would have led to longer trachael intubation, especially in those patients who were extubated within 10 hours of the completion of anesthesia.
对44例接受心脏手术患者进行气管拔管的决定基于对精神警觉性、肌力恢复、血流动力学稳定性和肺气体交换充分性的评估。没有患者需要重新插管。在开始自主通气试验前、自主通气45分钟后以及气管拔管后，同时测量肺活量（VC）和最大吸气压力（PImax）。根据普遍接受的标准，这些测量结果表明，在撤除机械通气支持时，有14例患者需要继续机械通气，在气管拔管时，有8例患者需要继续机械通气。在本研究中，考虑VC和PImax的测量结果会导致气管插管时间延长，尤其是那些在麻醉结束后10小时内拔管的患者。
