Objective To study the influencing factors for duration of mechanical ventilation in chronic obstructive pulmonary disease ( COPD) patients with type II respiratory failure. Methods Twenty-eight cases of mechanical ventilated COPD patients with type II respiratory failure were enrolled from March 2006 to March 2008 in Beijing Shunyi Hospital. They were divided into two groups based on their duration of ventilation: ≤7 d group as group I, and gt; 7 d as group II. Data of heart rate and blood pressure were recorded before the trachea intubation. Clinical data of blood routine, blood gas analysis and serum biochemistry were collected and analyzed. Previous history, smoking history and subsequent complications were also recorded. Results Heart rate in the group II were significantly higher than which in the group I[ ( 121. 50 ±17. 20) /min vs ( 103. 08 ±19. 97) /min, P lt;0. 05] . The incidences of upper gastrointestinal hemorrhage and blood pressure fall immediately after intubation were 63% and 88% respectively in the group II, which were significantly higher than the group I ( 0 and 25% ) . The levels of albumin, pre-albumin, Na+ , PaO2 were ( 29. 06 ±5. 00) g /L, ( 66. 36 ±17. 72) mg/L,( 138. 45 ±4. 74) mmol /L and ( 49. 06 ±20. 11) mm Hg respectively in the group II. While in the group I, those were ( 37. 11 ±2. 73) g /L, ( 127. 70 ±35. 84) mg/L, ( 143. 29 ±3. 42) mmol /L and ( 72. 25 ±38. 69) mm Hg respectively, which showed significant differences compared with the grouop II. The incidence of previous concomitant cerebral infarction showed significant difference between the group I and group II( 33. 33% vs 0) .Conclusion The levels of albumin, pre-albumin, heart rate before the intubation, upper gastrointestinal hemorrhage and blood pressure fall immediately after the intubation are associated with duration of mechanical ventilation and may indicate the prognosis in COPD patients with type II respiratory failure.
ObjectiveTo investigate the correlation between compliance of clinical respiratory bundle and duration of mechanical ventilation. MethodsThe data of patients who admitted to intensive care unit (ICU)of Cancer Hospital Chinese Academy of Medical Sciences between June 2013 and December 2014 were retrospectively reviewed and analyzed.The patients with respiratory insufficiency who ventilated more than 48 hours were included into the study. ResultsFifty-five patients were enrolled into the final analysis.There were 43 males and 12 females with a mean age of 63.47±12.49 years.The mean sequential organ failure assessment (SOFA)score was 2.8±2.2,and the mean simplified acute physiology score 3 (SAPS3)was 51±14 on ICU admission.The mean duration of mechanical ventilation of all 55 patients was 7.3±5.5 days.The compliance of low tidal volume strategy was 23.6%(13/55).No significant difference was found on duration of mechanical ventilation between the patients who was compliant with low tidal volume strategy and the patients who was not compliant (7.31±7.02 days vs. 7.31±5.07 day,P=0.444).A negative correlation between compliance of protocolized sedation strategy and duration of mechanical ventilation was found by Bivariate spearman correlation analysis (r2=0.312,P<0.001).A negative correlation between compliance of spontaneous awakening trial strategy and duration of mechanical ventilation (r2=0.337,P<0.001)and a negative correlation between compliance of spontaneous breathing trial strategy and duration of mechanical ventilation (r2=0.280,P<0.001)were also found by Bivariate spearman correlation analysis.Multiple linear regression analysis showed that only spontaneous awakening trial strategy was correlated with duration of mechanical ventilation(B=-0.623,P<0.001). ConclusionThe more compliance with clinical respiratory bundle,especially with spontaneous awakening trial strategy,the shorter of duration of mechanical ventilation.The effect of low tidal volume strategy on the duration of mechanical ventilation needs further studies.