METHODS: This was a retrospective cohort study of patients who were admitted to our Emergency Intensive Care Unit between September 1, 2020 and August 31, 2021 and were under artificial ventilation management for ≥ 24 h. The patients were divided into two groups: successful extubation and reintubation groups, and the relationship between CPEF immediately before extubation and reintubation was investigated.
RESULTS: Seventy-six patients were analyzed. In the univariate analysis, CPEF was significantly different between the successful extubation (90.7 ± 25.9 L/min) and reintubation (57.2 ± 6.4 L/min) groups (p < 0.001). In the multivariate analysis with age and duration of artificial ventilation as covariates, CPEF was significantly lower in the reintubation group (p < 0.01). The cutoff value of CPEF for reintubation according to the receiver operating characteristic curve was 60 L/min (area under the curve, 0.897; sensitivity, 78.5%; specificity, 90.9%; p < 0.01).
CONCLUSIONS: CPEF in tracheally intubated patients may be a useful indicator for predicting the risk of reintubation associated with decreased cough strength. The cutoff CPEF value for reintubation due to decreased cough strength was 60 L/min.
方法:这是一项回顾性队列研究,研究对象是2020年9月1日至2021年8月31日期间入住急诊重症监护病房并接受人工通气管理≥24h的患者。患者分为两组:成功拔管组和重新插管组,探讨拔管前CPEF与再插管前CPEF的关系。
结果:分析76例患者。在单变量分析中,成功拔管组(90.7±25.9L/min)和再插管组(57.2±6.4L/min)之间的CPEF差异有统计学意义(p<0.001)。在以年龄和人工通气持续时间为协变量的多变量分析中,再插管组CPEF明显降低(p<0.01)。根据受试者工作特性曲线,再插管的CPEF截止值为60L/min(曲线下面积,0.897;灵敏度,78.5%;特异性,90.9%;p<0.01)。
结论:气管插管患者的CPEF可能是预测与咳嗽强度降低相关的再插管风险的有用指标。由于咳嗽强度降低而重新插管的截止CPEF值为60L/min。