Risk factors for weaning failure in critical trauma patients with non-cardiac surgery

Lianze ZHAO; Chaofeng ZHANG; Qi CHEN; Hongwen NIU; Tao ZHU

doi:10.16016/j.2097-0927.202112167

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Risk factors for weaning failure in critical trauma patients with non-cardiac surgery

Clinical Medicine | 更新时间：2026-01-09

- Risk factors for weaning failure in critical trauma patients with non-cardiac surgery
- Journal of Army Medical University Vol. 44, Issue 16, Pages: 1661-1665(2022)
- 作者机构：
  
  201203 上海，上海中医药大学附属曙光医院创伤急救科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.2097-0927.202112167
  CLC： R181.32;R605.973;R641
- Received：22 December 2021，
  
  Revised：2022-03-02，
  
  Published：30 August 2022
- 稿件说明：
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Lianze ZHAO, Chaofeng ZHANG, Qi CHEN, et al. Risk factors for weaning failure in critical trauma patients with non-cardiac surgery[J]. Journal of Army Medical University, 2022, 44(16): 1661-1665.
DOI：

Lianze ZHAO, Chaofeng ZHANG, Qi CHEN, et al. Risk factors for weaning failure in critical trauma patients with non-cardiac surgery[J]. Journal of Army Medical University, 2022, 44(16): 1661-1665. DOI： 10.16016/j.2097-0927.202112167.

摘要

目的

分析创伤后非心脏手术重症患者脱离机械通气(脱机)失败的危险因素。

方法

选取2019年1月至2020年12月上海中医药大学附属曙光医院创伤急救科ICU病房收治的306例创伤后行非心脏手术且术后机械通气时间超过24 h的患者作为研究对象，回顾性分析入选患者的临床基线特征、化验结果、术中和术后资料，根据脱机结果将患者分为脱机成功组(

=222)与脱机失败组(

=84)。利用多元Logistic回归分析影响创伤后非心脏手术重症患者脱机失败的危险因素。

结果

纳入的306例患者中84名(27.4%)患者脱机失败。经单因素分析剔除混杂因素后，经过多元Logistic回归分析发现，年龄(

=1.835

95%

: 1.623~2.012

=0.002)、呼吸频率(

=1.860

95%

: 1.702~ 1.943

=0.001)、脑钠肽(brain natriuretic peptide，BNP)变化率(入ICU 24 h内BNP变化，

=3.366

95%

: 1.063~7.887

=0.000)、发生非心脏术后心肌损伤(

=4.237

95%

: 1.023~16.914

=0.001)是创伤后非心脏手术重症患者脱机失败的独立危险因素。

结论

高龄、呼吸频率升高、BNP水平升高、发生非心脏手术后心肌损伤(myocardial injury after non-cardiac surgery

MINS)是创伤后非心脏手术重症患者脱机失败的独立危险因素。

Abstract

Objective

To analyze the risk factors of weaning failure in posttraumatic critical patients with non-cardiac surgery.

Methods

A total of 306 patients with non-cardiac surgery who had mechanical ventilation more than 24 h after surgery

from January 2019 to December 2020

were included in this study. The clinical baseline characteristics

laboratory results

intraoperative and postoperative data of enrolled patients were retrospectively analyzed. These patients were divided into two groups: weaning success group (

=222) and weaning failure group (

=84). Risk factors for weaning failure in posttraumatic critical patients with non- cardiac surgery were determined by multivariate logistic regression analysis.

Results

Offline failure occurred in 84 out of 306 (27.4%) patients. After elimination of confounding factors by univariate analysis

multivariate logistic regression analysis showed that age(

=1.835

95%

: 1.623~2.012

=0.002)

respiratory frequency(

=1.860

95%

: 1.702~1.943

=0.001)

change rate of BNP(

=3.366

95%

: 1.063~ 7.887

=0.000) and myocardial injury after non-cardiac surgery(

=4.237

95%

: 1.023~16.914

=0.001) were the independent risk factors of weaning failure in post-traumatic critical patients with non-cardiac surgery.

Conclusion

Age

respiratory frequency

myocardial injury after non-cardiac surgery (MINS)

and increased change rate of BNP are independent risk factors of weaning failure in post-traumatic critical patients with non-cardiac surgery.

关键词

Keywords

references

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