自主呼吸试验指导慢性阻塞性肺疾病急性加重期有创机械通气撤离价值的初步评价

目的:研究自主呼吸试验(SBT)对慢性阻塞性肺疾病急性加重期(AECOPD)有创机械通气撤离的指导价值.方法:对因AECOPD进行有创机械通气治疗、分别采用SBT指导下撤机及传统撤机患者的临床资料进行对比,研究不同撤机技术对多个临床参数的影响.结果:采用传统撤机技术患者共19例,有创机械通气时间、住RICU时间及住院时...

Preliminary Evaluation of Spontaneous Breathing Test on Guiding Weaning of Invasive Mechanical Ventilation in Acute Exacerbation of COPD

Objective: To evaluate the value of spontaneous breathing test(SBT) on guiding weaning of invasive mechanical ventilation in acute exacerbation of COPD(AECOPD).Methods: The clinical data of AECOPD patients using SBT(n=38) and traditional techniques(n=19) to wean from invasive mechanical ventilation were compared.Results: The time of invasive mechanical ventilation,time of RICU stay and time of hospital stay were(9.2±6.5),(13.7±4.4),and(16.6±5.1) days respectively in traditional techniques group,versus(5.6±3.2),(6.9±2.3),and(8.7±2.6) days respectively in SBT group,and showed significant difference(P<0.05,P<0.001,and P<0.001,respectively).The re-intubation rate and incidence of ventilator-associated pneumonia(VAP) had no significant difference between the two groups.The sensitivity and specificity of SBT on guiding weaning in AECOPD were 0.91 and 0.94 respectively;positive predictive value and negative predictive values were 0.968 8 and 0.842 1 respectively.Conclusion: Using SBT guided weaning in invasive mechanical ventilation in AECOPD has significantly shorter time of invasive mechanical ventilation,time of RICU stay and time of hospital stay.Its accuracy is also better.This technique can help weaning in invasive mechanical ventilation patients.