浅快呼吸指数的变化趋势在机械通气撤离中的预测价值

目的对机械通气72 h以上的患者撤离呼吸机时,动态观察浅快呼吸指数(RSBI),以评价其预测撤机的价值。方法采用前瞻性研究方法,对满足常规撤机标准的76例患者,进行120 min自主呼吸试验(SBT),动态监测5、15、30、60及120 min五个时点的RSBI,根据撤机结果分为成功组和失败组。应用SPSS 15.0对测量数据进行重复测量资料的方差分析。结果 62例患者完成了120 min SBT,其中有20例撤机失败。撤机五个时点的RSBI无显著性差异(P0.05),但撤机成功组和撤机失败组之间五个时点的RSBI有显著性差异(P0.05)。结论机械通气72 h以上的患者撤机时,动态观察RSBI的变化趋势对判断撤机能否成功更有价值,而独立观察RSBI的价值有限。

Variation Trend of Rapid Shallow Breathing Index in Prediction of Ventilator Weaning Process

Objective To determine the usefulness of serial measurements of the rapid shallow breathing index（f/VT,RSBI） as a predictor for successfully weaning of patients undergoing prolonged mechanical ventilation（72 hours）.Methods 76 mechanically ventilated patients were prospectively analyzed.120-min spontaneous breathing trial was conducted after the patients having fullfiled the traditional weaning criteria,and RSBI were continuously monitored by the ventilator at five time points（5,15,30,60,and 120 min）.A repeated measure of general linear model in SPSS 15.0 was conducted to analyze the data.Results 62 patients completed 120-minute spontaneous breath trial and in which 20 patients failed weaning.There was no significant difference of RSBI at five time points during weaning（P0.05）.But the variation trends of RSBI during weaning time were significant different between the successful weaning patients and the failed weaning patients（P0.05）.Conclusions In patients undergoing prolonged mechanical ventilation,the variation trend of RSBI is more valuable than single RSBI in the prediction of successful weaning.