呼吸衰竭病人延遲脫離的影響因子初探

Monitoring Patient Medication Safety Using a Renal Excretion Drug Monitoring System for Diabetic Medications Containing Metformin

目的：延遲脫離影響著病人住院期間的死亡率及拔管成功率，本研究主在探討延遲脫離的影響因子，期待結果能幫助照護團隊瞭解並改善延遲脫離的發生。方法：回溯性研究，收集台灣南部某教學醫院於加護病房使用機械通氣經專責醫師評估病況穩定且執行計劃性拔管後120 小時未再插管之臨床病資。以SPSS 18.0 進行統計分析，定義統計顯著為p < 0.05。結果：簡單、困難、延遲脫離各組的累計發生個數（率）分別為745（49.4%）、508（33.7%）及255（16.9%）。有較高比例的延遲脫離病例插管原因在肺炎；呼吸衰竭種類屬肺部呼吸道系統者。結論：多因素logistic regression model 分析顯示：插管天數長、呼吸衰竭種類為肺部呼吸道系統及因換氣不足插管者，延遲脫離的勝算高。

Objectives: Prolonged weaning affects mortality and the extubation success rate during hospitalization. The aim of the present study was to discuss the factors impacting prolonged weaning of respiratory failure patients. The research results are expected to help medical care teams understand and improve the incidence of prolonged weaning. Methods: This was a retrospective study. The medical records data were collected from a regional teaching hospital in southern Taiwan. The patients were admitted to the intensive care unit, intubated, and mechanical ventilation was initiated. When a patient was stable based on attending physician assessment, planned extubation was performed for at least 120 h without re-intubation. Statistical analyses were conducted on the data using SPSS 18.0. The level of signifi cance was set at 0.05. Results: The cumulative incidences of the simple, difficult, and prolonged weaning groups were 49.4%, 33.7%, and 16.9%, respectively. A higher proportion of patients with prolonged weaning were intubated for pneumonia and pulmonary respiratory failure types. Conclusions: Based on a multivariate logistic regression model analysis, intubation days, pulmonary respiratory failure types, and intubation due to hyperventilation had a greater odds of prolonged weaning.