心脏超声参数及LUS对AECOPD合并呼吸衰竭患者机械通气撤机结局的预测价值

doi:10.3969/j.issn.1671-7171.2023.04.015

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1220 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要【目的】探讨心脏超声参数及肺部超声评分(LUS)对慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭患者机械通气撤机结局的预测价值。【方法】选取2018年5月至2021年3月榆林市第二医院收治的125例AECOPD合并呼吸衰竭患者,统计所有患者机械通气撤机结局,采用Logistic多因素回归分析AECOPD合并呼吸衰竭患者机械通气撤机结局的影响因素;采用受试者工作特征(ROC)曲线下面积(AUC)评估心脏超声参数及LUS对AECOPD合并呼吸衰竭患者机械通气撤机结局的预测价值。【结果】125例AECOPD合并呼吸衰竭患者中有24例撤机失败,剩余101例撤机成功。Logistic多因素分析显示:浅快呼吸指数(RSBI)、LUS、舒张早期左房室瓣血流速度(V₁)/舒张早期左房室瓣环运动速度(V₃)是影响AECOPD合并呼吸衰竭患者机械通气撤机结局的独立因素(OR:3.673、4.450、3.442,95%CI:1.511~8.927、1.831~10.816、1.416~8.365,P<0.05)。ROC曲线分析结果显示:LUS、V₁/V₃及两者联合预测AECOPD合并呼吸衰竭患者机械通气撤机结局的AUC分别为0.776、0.782、0.882。【结论】AECOPD合并呼吸衰竭患者机械通气撤机失败风险较高,心脏超声参数V₁/V₃、LUS与患者机械通气撤机结局有关,二者联合预测撤机结局效能更好。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	常凯悦
	李军社

关键词 ：肺疾病,慢性阻塞性/并发症, 呼吸功能不全/并发症, 肺疾病,慢性阻塞性/影像诊断, 呼吸,人工, 病人结局评价

Abstract：【Objective】 To explore the predictive value of cardiac ultrasound parameters and lung ultrasound score (LUS) on the outcome of mechanical ventilation withdrawal in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and respiratory failure. 【Methods】 A total of 125 patients with AECOPD and respiratory failure admitted to the Second Hospital of Yulin City from May 2018 to March 2021 were selected,and the outcome of mechanical ventilation withdrawal was statistically analyzed for all patients. Logistic multivariate regression analysis was used to analyze the influencing factors of mechanical ventilation withdrawal outcome for AECOPD and respiratory failure patients; The predictive value of cardiac ultrasound parameters and LUS on the outcome of mechanical ventilation withdrawal in AECOPD patients with respiratory failure was evaluated using the area under the subject operating characteristic (ROC) curve (AUC). 【Results】 Of the 125 patients with AECOPD and respiratory failure,24 failed to wean,while the remaining 101 were successfully weaned. Logistic multivariate analysis showed that shallow rapid respiratory index (RSBI),LUS,and early diastolic left atrioventricular valve flow velocity (V₁)/early diastolic left atrioventricular annular motion velocity (V₃) were independent factors affecting the outcome of mechanical ventilation withdrawal in AECOPD patients with respiratory failure (OR:3.673,4.450,3.442,95%CI:1.511-8.927,1.831-10.816,1.416-8.365,P<0.05). The results of ROC curve analysis showed that the AUC of LUS,V₁/V₃,and their combination in predicting the outcome of mechanical ventilation withdrawal in AECOPD patients with respiratory failure were 0.776,0.782,and 0.882,respectively. 【Conclusion】 Patients with AECOPD and respiratory failure have a higher risk of mechanical ventilation withdrawal failure. Cardiac ultrasound parameters V₁/V₃ and LUS are related to the outcome of mechanical ventilation withdrawal,and the combination of the two is more effective in predicting the outcome of mechanical ventilation withdrawal.

Key words： Pulmonary Disease,Chronic Obstructive/CO Respiratory Insufficiency/CO Pulmonary Disease,Chronic Obstructive/DG Respiration,Artificial Patient Outcome Assessment

收稿日期: 2022-04-21

中图分类号:

R563

通讯作者: * E-mail:1114835819@qq.com

引用本文:

常凯悦, 李军社. 心脏超声参数及LUS对AECOPD合并呼吸衰竭患者机械通气撤机结局的预测价值[J]. 医学临床研究, 2023, 40(4): 535-538.
CHANG Kai-yue, LI Jun-she. Predictive Value of Cardiac Ultrasound Parameters and LUS on the Outcome of Mechanical Ventilation withdrawal in Patients with AECOPD and Respiratory Failure. JOURNAL OF CLINICAL RESEARCH, 2023, 40(4): 535-538.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.04.015 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I4/535

[1] DEMOULE A,BROCHARD L,DRES M,et al. How to ventilate obstructive and asthmatic patients[J].Intensive Care Med,2020,46(12):2436-2449.
[2] MESQUIDA J,GRUARTMONER G,ESPINAL C,et al. Thenar oxygen saturation (StO₂) alterations during a spontaneous breathing trial predict extubation failure[J].Ann Intensive Care,2020,10(1):54-58.
[3] KHANJI M Y,RICCI F,PATEL R S,et al. Special rticle-the role of hand-held ultrasound for cardiopulmonary assessment during a pandemic[J].Prog Cardiovasc Dis,2020,63(5):690-695.
[4] 李萍,林桦,张爱丽,等. 血清磷水平与老年慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭患者机械通气撤机结局的相关性分析[J].中华老年医学杂志,2020,39(6):613-617.
[5] 乔智灏,夏厦,刘昶,等. SBT联合BNP监测对COPD患者拔管结局的预测价值[J].国际呼吸杂志,2020,40(8):587-591.
[6] 吴敬医,詹勇,余晔,等. 红细胞分布宽度对AECOPD患者机械通气撤机结局的预测价值[J].皖南医学院学报,2019,38(5):425-429.
[7] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
[8] ROCHWERG B,BROCHARD L,ELLIOTT M W,et al. Official ERS/ATS clinical practice guidelines:noninvasive ventilation for acute respiratory failure[J].Eur Respir J,2017,50(2):1602426.
[9] GODINJAK A,IGLICA A,RAMA A,et al. Predictive value of SAPS Ⅱ and APACHE Ⅱ scoring systems for patient outcome in a medical intensive care unit[J].Acta Med Acad,2016,45(2):97-103.
[10] 床旁超声在急危重症临床应用专家共识组. 床旁超声在急危重症临床应用的专家共识[J].中华急诊医学杂志,2016,25(1):10-21.
[11] 宋明利,巨芳萍. COPD患者肌肉抑制素,HCT,炎症细胞因子水平变化及其与肺功能的关系[J].中国急救复苏与灾害医学杂志,2019,14(12):1187-1190.
[12] BOLLMEIER S G,HARTMANN A P. Management of chronic obstructive pulmonary disease:a review focusing on exacerbations[J].Am J Health Syst Pharm,2020,77(4):259-268.