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Predictors of successful weaning from prolonged mechanical ventilation in Taiwan.
MedLine Citation:
PMID:  19359156     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: For adult patients on prolonged mechanical ventilation (PMV, >/=21 days), successful weaning has been attributed to various factors. The purpose of this study was to describe patient outcomes, weaning rates and factors in successful weaning at a hospital-based respiratory care center (RCC) in Taiwan. METHODS AND RESULTS: This was a retrospective observational study performed in a 24-bed RCC over six years. A total of 1307 patients on PMV were included in the study. The overall survival rate was 62%. Fifty-six percent of patients were successfully weaned. Unsuccessfully weaned patients had higher MICU transfer rates, higher Acute Physiology and Chronic Health Evaluation II scores, longer duration of RCC stay, higher rates of being bed-ridden prior to admission, increased hemodialysis rates, higher modified Glasgow Coma Scale scores, higher rapid shallow breathing index, lower inspiratory pressure at residual volume (PImax) and lower blood urea nitrogen (BUN) and creatinine levels. Factors found to be associated with unsuccessful weaning were length of RCC stay (OR=1.04, P<0.001), modified GCS score (OR=0.93, P<0.046), PImax (OR=0.97, P<0.001), serum albumin concentration (OR=0.62, P<0.023) and BUN level (OR=1.01, P<0.002). CONCLUSION: High rates of ventilator independence can be achieved in an RCC setting as an alternative to ICU care. Factors associated with unsuccessful weaning included longer duration of RCC stay, elevated BUN levels and lower modified GCS scores, serum albumin and PImax levels.
Authors:
Yao-Kuang Wu; Kuo-Chin Kao; Kuang-Hung Hsu; Meng-Jer Hsieh; Ying-Huang Tsai
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Publication Detail:
Type:  Journal Article     Date:  2009-04-09
Journal Detail:
Title:  Respiratory medicine     Volume:  103     ISSN:  1532-3064     ISO Abbreviation:  Respir Med     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-06-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1189-95     Citation Subset:  IM    
Affiliation:
Division of Pulmonary and Critical Care Medicine, Buddhist Tzu Chi General Hospital, Taipei, Taiwan.
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