多脏器超声预测机械通气脱机失败价值

目的:探讨多脏器超声对机械通气患者脱机结果的预测价值。方法:本研究为病例对照研究，采用非随机抽样的方法选择2019年6月-2020年6月邯郸市第一医院ICU收治的机械通气患者62例。成功通过自主呼吸试验(SBT)后进行多脏器超声检查，记录肺部超声评分(LUS)、舒张早期左心房室瓣血流速度/舒张早期左心房室瓣环运动速度(...

Predictive value of multi-organ ultrasonic in weaning failure of mechanical ventilation

Objective To investigate the predictive value of multi-organ ultrasound on weaning results of patients with mechanical ventilation.Methods This is a case-control study,a non-random sampling method enrolled 62 inpatients who underwent mechanical ventilation in ICU of the First Hospital of Handan from June 2019 to June 2020.After successful spontaneous breathing test(SBT),multiple organ ultrasound examination was performed to record lung ultrasound score(LUS),early transmitral flow velocity/early diastolic velocity of the mitral valve annulus(E/e′),diaphragmatic rapid shallow breathing index(DRSBI),the patients were divided into success group and failure group according whether or not successfully weaning from invasive ventilation.The ultrasound detection results of multiple organs after SBTwere compared between the two groups.The receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of multi-organ ultrasound for weaning failure.Results Among the 49 patients who successfully passed SBT,37 cases were successfully weaned as success group,and 12 cases were failed after SBT as failure group.LUS,E/e′and DRSBI of patients in failure group were higher than those of patients in success group(LUS6.83±2.82 vs 3.59±2.23]score,E/e′16.06±2.39 vs 12.44±2.41]and DRSBI1.67±0.28 vs 1.31±0.19]time·min-1·mm-1 respectively).The difference were statistivally significant(all P<0.05).ROC curve showed that AUC,sensitivity and specificity of the combined predicting weaning failure by multi-organ ultrasound were 0.95,91.0%and 98.0%,which were higher than the prediction results of the three indexes alone.Conclusions For patients with mechanical ventilation,the combined of Multi-organ ultrasound is capable effectively predicting weaning failure,and finding the cause of the failure.