PetCO_(2)对SCAP机械通气患者撤机时机的预测价值  

Predictive value of PetCO_(2) on weaning time in patients with SCAP mechanical ventilation

作　　者：何凌[1] 鲁玉婷 HE Ling;LU Yuting(Respiratory and Critical Care Medicine Department,Luohe Central Hospital,Luohe 462000;No.2 Internal Medicine Department,Luohe Hospital of Traditional Chinese Medicine,Luohe 462000,China)

机构地区：[1]漯河市中心医院呼吸与危重症医学科,河南漯河462000 [2]漯河市中医院内二科,河南漯河462000

出　　处：《临床医学研究与实践》2022年第6期129-131,共3页Clinical Research and Practice

摘　　要：目的探讨呼吸末二氧化碳分压(PetCO2)对重症社区获得性肺炎(SCAP)机械通气患者撤机时机的预测价值。方法选取2017年1月至2020年12月本院87例SCAP机械通气患者作为研究对象,采用自主呼吸试验(SBT)对患者进行撤机筛查,符合撤机标准者予以撤机,根据拔管后48 h是否需要复插或通气支持将其分为撤机成功组与撤机失败组,比较两组的一般资料。采用受试者工作特征(ROC)曲线分析PetCO2对撤机成功的预测价值。结果 87例患者中,55例撤机成功,32例撤机失败。两组的年龄、性别、心率、平均动脉压、APACHEⅡ评分、分钟通气量、机械通气时间、静态顺应性、氧合指数、合并糖尿病、应用血管活性药物、浅快呼吸指数(RSBI)比较,差异无统计学意义(P>0.05);撤机成功组的PetCO2低于撤机失败组,差异具有统计学意义(P<0.05)。ROC曲线分析显示,将PetCO2≤33 mmHg作为撤机成功的预测节点,灵敏度、特异度分别为88.69%、70.49%,ROC曲线下面积(AUC)为0.764。结论 PetCO2可有效预测SCAP机械通气患者的撤机时机,具有操作简单、灵敏度及特异度高的优点。Objective To explore the predictive value of end-tidal carbon dioxide partial pressure(PetCO_(2)) on weaning time in patients with severe community-acquired pneumonia(SCAP) mechanical ventilation.Methods A total of 87 patients with SCAP mechanical ventilation in our hospital from January 2017 to December 2020 were selected as the research objects.The patients were screened for weaning by spontaneous breathing test(SBT).Those who met the weaning criteria were weaned.The patients were divided into weaning success group and weaning failure group according to the need for reinsertion or ventilation support at 48 h after extubation,the general data of the two groups were compared.The receiver operating characteristic(ROC) curve was used to analyze the predictive value of PetCO_(2) on the weaning success.Results Among 87 patients,55 cases weaning success and 32 cases weaning failure.There were no significant differences in age,gender,heart rate,mean arterial pressure,APACHE Ⅱ score,minute ventilation,mechanical ventilation time,static compliance,oxygenation index complicated with,diabetes mellitus,used vasoactive drugs and rapid shallow breathing index(RSBI) between the two groups(P>0.05);PetCO_(2) in the weaning success group was lower than that in the weaning failure group,and the difference was statistically significant(P <0.05).ROC curve analysis showed that when PetCO_(2)≤33 mmHg as the prediction node for weaning success,the sensitivity and specificity were 88.69% and 70.49% respectively,and the area under the ROC curve(AUC) was 0.764.Conclusion PetCO_(2) can effectively predict the weaning time in patients with SCAP mechanical ventilation.It has the advantages of simple operation,high sensitivity and specificity.

关 键 词：呼吸末二氧化碳分压 重症社区获得性肺炎 机械通气 撤机时机 

分 类 号：R459.7[医药卫生—急诊医学]