- 期刊
【論文摘要】FRC and respiratory physiological change in relation to the weaning outcome in RCC prolonged mechanical ventilation patients
【論文摘要】呼吸器脫離在長期呼吸器依賴患者自主呼吸訓練時肺餘容積與呼吸參數之變化
摘要
Introduction: No previous studies have investigated the role of functional residual capacity (FRC) in predicting weaning outcomes in the RCC. This study was aimed to evaluate the change in FRC during a spontaneous breathing trial (SBT) and metabolic parameters in patients with prolonged mechanical ventilation (PMV) (＞ 21 days), and also to evaluate the change in FRC, O_2 consumption (VO2), CO_2 production (VCO_2) and breathing variables in PMV patients. Method: This is a prospective, single center, observational study in a 16-bed respiratory care center (RCC). The study included patients with PMV time ＞ 21 days. Patients who are willing for an SBT were enrolled. During the 3-month study period, 31 eligible patients were divided into either the weaning success group (n = 21) or the weaning failure group (n = 10). The rapid shallow breathing index (RSBI), FRC, VO_2 and VCO_2 were assessed before SBT (T0) and after one-hour SBT (T1) and after 24 hours SBT (T2). The FRC was measured by the nitrogen washin-washout method. The VO_2 and VCO_2 were measured by the metabolic computer (Engstrom). Weaning success was defined as liberation from mechanical ventilation for 5 days. The effectiveness of each indicator was tested using generalized estimating equation (GEE) analysis on the two groups at different time points. Result: All patients had undergone tracheostomy and the overall weaning success rate was 67.7%. In the weaning success group. The FRC was increased significantly from 1029 (T0) to1273 (T1) (p＜0.018) and VCO_2 was increased significantly from 138 (T0) to153 (T1) (p＜0.008), and the RR was decreased significantly from 26 (T0) to 23 (T1) (p＜0.000) during the SBTs. In the failure group no significant change was noted in all the variables. Conclusion: FRC has potential value in predicting the weaning outcome of prolong mechanical ventilation patients. RR decrease and VCO_2 increase presented significant change. However, RSBI has limited value in predicting weaning outcomes of PMV in this study. (The form abridges)