METHODS: This study was a reanalysis of the data of 60 difficult-to-wean patients in a previous study published in 2017. All eligible participants were organized into respiratory failure (RF) group and extubation success (ES) group within 48 h after extubation, or re-intubation (RI) group and non-intubation (NI) group within 1 week after extubation. The risk factors for respiratory failure and re-intubation including E/Ea and △E/Ea, DE and △DE at different positions were analyzed by multivariate logistic regression, respectively. The receiver operating characteristic (ROC) curves of E/Ea (septal, lateral, average) and DE (right, left, average) were compared with each other, respectively.
RESULTS: Of the 60 patients, 29 cases developed respiratory failure within 48 h, and 14 of those cases required re-intubation within 1 week. Multivariate logistic regression showed that E/Ea were all associated with respiratory failure, while only DE (right) and DE (average) after SBT were related to re-intubation. There were no statistic differences among the ROC curves of E/Ea at different positions, nor between the ROC curves of DE. No statistical differences were shown in △E/Ea between RF and ES groups, while △DE (average) was remarkably higher in NI group than that in RI group. However, multivariate logistic regression analysis showed that △DE (average) was not associated with re-intubation.
CONCLUSIONS: E/Ea at different positions during a SBT could predict postextubation respiratory failure with no statistical differences among them. Likewise, only DE (right) and DE (average) after SBT might predict re-intubation with no statistical differences between each other.
方法:这项研究是对2017年发表的先前研究中60名难以断奶的患者的数据进行的重新分析。所有符合条件的参与者在拔管后48h内分为呼吸衰竭(RF)组和拔管成功(ES)组。拔管后1周内或再插管(RI)组和非插管(NI)组。呼吸衰竭和再插管的危险因素包括E/Ea和△E/Ea。采用多元逻辑回归分析不同位置的DE和△DE,分别。E/Ea(间隔,横向,平均值)和DE(右,左,平均值)相互比较,分别。
结果:在60名患者中,29例48h内出现呼吸衰竭,其中14例需要在1周内重新插管。多因素logistic回归分析显示E/Ea均与呼吸衰竭相关,而SBT后只有DE(右)和DE(平均)与再插管有关。E/Ea在不同位置的ROC曲线之间没有统计学差异。在DE的ROC曲线之间也是如此。RF组和ES组△E/Ea差异无统计学意义。NI组的△DE(平均值)明显高于RI组。然而,多因素logistic回归分析显示△DE(平均值)与再次插管无关。
结论:在SBT期间不同位置的E/Ea可以预测拔管后呼吸衰竭,但它们之间没有统计学差异。同样,SBT后只有DE(右)和DE(平均)可以预测再次插管,彼此之间没有统计学差异.