Risk Factors and Outcomes of Patients with Prolonged Mechanical Ventilation after Successful Weaning

長期機械通氣病人在成功脫離呼吸器後再放置呼吸器的危險因子及預後

陳泓丞(Hung-Cheng Chen) ； 林孟志(Meng-Chih Lin) ； 林安伸(An-Shen Lin) ； 王金洲(Chin-Chou Wang) ； 王逸熙(Yi-Hsi Wang)

《胸腔醫學》 27卷4期 (2012/08) Pp. 209-216

https://doi.org/10.29806/TM.201208.0002

摘要

Prolonged mechanical ventilation (PMV) places a large burden on patients, families, and healthcare resources. Some of these patients are successfully weaned and discharged, but some experience recurrent respiratory failure and undergo reinstitution of mechanical ventilation (MV). The purpose of this paper is to identify the risk factors that lead to reinstitution of MV in patients who have undergone successful weaning, and to evaluate their outcome. From January 2006 to December 2007, 314 patients were successfully weaned in the respiratory care center (RCC) of Chang Gang Memorial Hospital. Patients with reinstitution of MV were compared to patients without reinstitution of MV to identify the risk factors that lead to reinstitution. The observation period was from the day of RCC admission to the day of discharge from the hospital. Of the 314 patients, 133 (42.4%) underwent reinstitution of MV due to recurrent respiratory failure, and 181 (57.6%) were discharged without reinstitution. Patients without tracheostomy (p＜0.005) had an increased incidence of reinstitution. Seventeen percent of PMV patients expired during RCC admission and 78 (58.7%) of the 133 patients that received reinstitution of MV expired during hospitalization. The incidence of MV reinstitution after successful weaning is increased in patients without tracheostomy and in those with congestive heart failure as the cause of acute respiratory failure. The prognosis of patients with MV reinstitution is poor.

關鍵字

長期機械通氣 ； 再放置呼吸器

並列摘要

Prolonged mechanical ventilation (PMV) places a large burden on patients, families, and healthcare resources. Some of these patients are successfully weaned and discharged, but some experience recurrent respiratory failure and undergo reinstitution of mechanical ventilation (MV). The purpose of this paper is to identify the risk factors that lead to reinstitution of MV in patients who have undergone successful weaning, and to evaluate their outcome. From January 2006 to December 2007, 314 patients were successfully weaned in the respiratory care center (RCC) of Chang Gang Memorial Hospital. Patients with reinstitution of MV were compared to patients without reinstitution of MV to identify the risk factors that lead to reinstitution. The observation period was from the day of RCC admission to the day of discharge from the hospital. Of the 314 patients, 133 (42.4%) underwent reinstitution of MV due to recurrent respiratory failure, and 181 (57.6%) were discharged without reinstitution. Patients without tracheostomy (p＜0.005) had an increased incidence of reinstitution. Seventeen percent of PMV patients expired during RCC admission and 78 (58.7%) of the 133 patients that received reinstitution of MV expired during hospitalization. The incidence of MV reinstitution after successful weaning is increased in patients without tracheostomy and in those with congestive heart failure as the cause of acute respiratory failure. The prognosis of patients with MV reinstitution is poor.

並列關鍵字

prolonged mechanical ventilation ； reinstitution of ventilator