Daley B J, Garcia-Perez F, Ross S E
Department of Surgery, Cooper Hospital/University Medical Center, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Camden, USA.
Chest. 1996 Dec;110(6):1577-80. doi: 10.1378/chest.110.6.1577.
Determine reintubation rate, identify its cause, and detail adverse outcomes from reintubation.
Retrospective review of extubation failures in the trauma ICU.
University hospital and regional trauma center.
Four hundred five patients arriving intubated or requiring intubation during hospitalization after 2,516 traumatic injury admissions over 18 months.
None.
Reintubation incidence was 7% (27 times per 405 patients). Comparative mortality of the reintubated group (2/24 = 8%) is similar to overall trauma center mortality (224/2516 = 6.5%), but less than the cohort of patients admitted to the hospital intubated (63/405 = 16%). Reintubated patients had an increased frequency of stridor than reported previously (33%), and an increased tracheostomy rate (62% vs 30%). Stridor was not predictable from injury severity score, Glasgow coma score, age, sex, length of intubation, or place of intubation. Pulmonary complications (atelectasis, tracheobronchitis, pneumonia) developed in half of reintubated patients; stridorous patients did not have an increased rate of pulmonary complications.
Reintubation in trauma ICU patients does not predict poor outcome.
确定再次插管率，找出其原因，并详细说明再次插管的不良后果。
对创伤重症监护病房（ICU）拔管失败情况进行回顾性研究。
大学医院和地区创伤中心。
在18个月内，2516例创伤患者入院后，405例住院期间插管或需要插管的患者。
无。
再次插管发生率为7%（405例患者中发生27次）。再次插管组的相对死亡率（2/24 = 8%）与创伤中心总体死亡率（224/2516 = 6.5%）相似，但低于入院时已插管患者队列（63/405 = 16%）。再次插管患者喘鸣频率高于先前报道（33%），气管切开率增加（62%对30%）。根据损伤严重程度评分、格拉斯哥昏迷评分、年龄、性别、插管时间或插管地点无法预测喘鸣。一半的再次插管患者出现肺部并发症（肺不张、气管支气管炎、肺炎）；喘鸣患者的肺部并发症发生率并未增加。
创伤ICU患者再次插管并不能预测预后不良。
