اعتباریابی شاخص PaO2 / PALVO2 ÷ RSBI × FiO2 در جداسازی بیماران مزمن انسدادی ریوی از دستگاه تهویه مکانیکی: یک کارآزمایی بالینی سه¬سوکور چند مرکزه آینده¬نگر مشاهده¬ای

امیر واحدیان عظیمی

چکیده


زمينه و هدف: جداسازي از دستگاه تهوية مكانيكي يكي از
چالش برانگيزترين موضوعات بيماران مبتلا به نارسايي مزمن
انسدادي ريوي بستري در بخش مراقبت ويژه است. معرفي
شاخص جديد كه بتواند با احتمال بيشتري موفقيت
جداسازي اين بيماران را از دستگاه تهوية مكانيكي پيش بيني
. كند، بسيار حائز اهميت است. مطالعة حاضر با دو هدف 1
تعيين نقاط برش شاخص واحديان يك و شاخصهاي رايج
در جمعيت بيماران IWI و CROP ،NIF ،P0.1 ،RSBI
مزمن انسدادي ريوي و 2. مقايسة مؤلفههاي مختلف
جداسازي از دستگاه تهوية مكانيكي شاخص واحديان يك و
در جمعيت IWI و CROP ،NIF ،P0.1 ،RSBI شاخصهاي
بيماران مزمن انسدادي ريوي انجام شده است.
روشبررسي: مطالعة حاضر يك كارآزمايي باليني سهسوكور
چند مركزه آيندهنگر مشاهدهاي بوده كه از بهمن 1392 تا
اسفند 1393 در جامعة بيماران مزمن انسدادي ريوي بستري
در بخش مراقبتهاي ويژه بيمارستانهاي منتخب شهر تهران
در دو گروه تعيين نقطة برش (تعداد = 90 ) و گروه تعيين
مؤلفههاي پيشبيني كنندة جداسازي از دستگاه تهوية
مكانيكي (تعداد = 90 ) انجام شد. فرآيند جداسازي از دستگاه
تهوية مكانيكي در هر دو گروه يكسان و بر اساس پروتكل
تعريف شده انجام شد. از تحليل راك براي تعيين نقاط برش
در گروه اول و تعيين مؤلفههاي پيش بيني كننده در گروه دوم
استفاده شد.

تمام متن:

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مراجع


Danckers M, Grosu H, Jean R, Cruz RB, Fidellaga A, Han Q, et al. Nurse-driven, protocol-directed weaning from

mechanical ventilation improves clinical outcomes and is well accepted by intensive care unit physicians. Journal of

critical care. 2013;28(3): 433 - 441.

Chung TN, Yoon I, You JS, Lee JY, Park I, Chung SP, et al. Mechanical ventilation in the emergency department

for 24 hours or longer is associated with delayed weaning. Journal of critical care. 2012;27(6):740. e9-. e15.

Morato JB, Sakuma MT, Ferreira JC, Caruso P. Comparison of 3 modes of automated weaning from mechanical

ventilation: a bench study. Journal of critical care. 2012;27(6):741. e1-. e8.

Farghaly S, Galal M, Hasan AA, Nafady A. Brain natriuretic peptide as a predictor of weaning from mechanical

ventilation in patients with respiratory illness. Australian Critical Care. 2015. In Press.

Lima EJ. Respiratory rate as a predictor of weaning failure from mechanical ventilation. Brazilian journal of

anesthesiology (Elsevier). 2013;63 (1):1- 6.

Carron M, Rossi S, Carollo C, Ori C. Comparison of invasive and noninvasive positive pressure ventilation

delivered by means of a helmet for weaning of patients from mechanical ventilation. Journal of critical care. 2014;

(2): 456 – 657.

Khalil Y, Ibrahim E, Shabaan A, Imam M, Behairy AE. Assessment of risk factors responsible for difficult

weaning from mechanical ventilation in adults. Egyptian Journal of Chest Diseases and Tuberculosis.

;61(3):159-66.

El-Shimy WS, Barima MA, Abo El-Magd GH, Mansour SA. Non invasive ventilation versus synchronized

intermittent mandatory ventilation with pressure support in weaning of COPD patients: Comparative study. Egyptian

Journal of Chest Diseases and Tuberculosis. 20.66- 159:(1)62;13

Muttini S, Villani PG, Trimarco R, Bellani G, Grasselli G, Patroniti N. Relation between peak and integral of the

diaphragm electromyographic activity at different levels of support during weaning from mechanical ventilation: A

physiologic study. Journal of critical care. 2015;30(1):7-12.

Vargas F, Boyer A, Bui HN, Salmi LR, Guenard H, Gruson D, et al. Respiratory failure in chronic obstructive

pulmonary disease after extubation: value of expiratory flow limitation and airway occlusion pressure after 0.1

second (P0. 1). Journal of critical care. 2008;23(4):577-84.

Li J-M, Cheng S-Z, Cai W, Zhang Z-H, Liu Q-H, Xie B-Z, et al. Transitional Care for Patients with Chronic

Obstructive Pulmonary Disease. International Journal of Nursing Sciences. 2014; 34(1): 432 – 567.

Ng L, Chiang LK, Tang R, Siu C, Fung L, Lee A, et al. Effectiveness of incorporating Tai Chi in a pulmonary

rehabilitation program for Chronic Obstructive Pulmonary Disease (COPD) in primary care—A pilot randomized

controlled trial .European Journal of Integrative Medicine. 2014;6(3):248-58.

Disler RT, Green A, Luckett T, Newton PJ, Currow D, Davidson PM. Experience of Advanced Chronic

Obstructive Pulmonary Disease: Metasynthesis of Qualitative Research. Journal of pain and symptom management.

; 21(2): 21 – 34.

Kawut SM, Poor HD, Parikh MA, Hueper K, Smith BM, Bluemke DA, et al. Cor pulmonale parvus in chronic

obstructive pulmonary disease and emphysema: the MESA COPD study. Journal of the American College of

Cardiology. 2014;64(19):20.9-00

Ismaeil MF, El-Shahat HM, El-Gammal MS, Abbas AM. Unplanned versus planned extubation in respiratory

intensive care unit, predictors of outcome. Egyptian Journal of Chest Diseases and Tuberculosis. 2014;63(1):219-31.

Elgazzar AE, Walaa M, Salah A, Yousif AR. Evaluation of the minute ventilation recovery time as a predictor of

weaning in mechanically ventilated COPD patients in respiratory failure. Egyptian Journal of Chest Diseases and

Tuberculosis. 2013;62(2):287-92.

Condessa RL, Brauner JS, Saul AL, Baptista M, Silva AC, Vieira SR. Inspiratory muscle training did not

accelerate weaning from mechanical ventilation but did improve tidal volume and maximal respiratory pressures: a

randomised trial. Journal of physiotherapy. 2013;59(2):101.7-

Roh JH, Synn A, Lim C-M, Suh HJ, Hong S-B, Huh JW, et al. A weaning protocol administered by critical care

nurses for the weaning of patients from mechanical ventilation. Journal of critical care. 2012;27(6):549-55.

Nemer SN, Barbas CS, Caldeira JB, Cárias TC, Santos RG, Almeida LC, et al. A new integrative weaning index

of discontinuation from mechanical ventilation. Critical Care. 2009;13(5):R152.

Yang KL, Tobin MJ. A prospective study of indexes predicting the outcome of trials of weaning from mechanical

ventilation. New England Journal of Medicine. 1991;324(21):1445-50.

Tobin MJ. Advances in mechanical ventilation. New England Journal of Medicine. 2001;344(26):1986-96.

Isaza GD, Posner JD, Altose MD, Kelsen SG, Cherniack NS. Airway occlusion pressures in awake and

anesthetized goats. Respiration Physiology. 1976;27(1):87-98.

Van Rynen JL, Rega PP, Budd C, Burkholder-Allen KJ. The Use of Negative Inspiratory Force by ED Personnel

to Monitor Respiratory Deterioration in the Event of a Botulism-induced MCI. Journal of Emergency Nursing.

;35(2):114-7.

Huaringa AJ, Wang A, Haro MH, Leyva FJ. The Weaning Index as Predictor of Weaning Success. Journal of

intensive care medicine. 2012; 21(2): 33 – 42.

Jabour ER ,Rabil DM, Truwit JD, Rochester DF. Evaluation of a new weaning index based on ventilatory

endurance and the efficiency of gas exchange. Am Rev Respir Dis. 1991;144(3 Pt 1):531-7.

Ferrari G, De Filippi G, Elia F, Panero F, Volpicelli G, Apra F. Diaphragm ultrasound as a new index of

discontinuation from mechanical ventilation. Critical ultrasound journal. 2014;6(1):8 - 15.

de Souza LC, Guimaraes FS, Lugon JR. Evaluation of a new index of mechanical ventilation weaning: the timed

inspiratory effort. J Intensive Care Med. 2015;30(1):37-43.

Delisle S, Francoeur M, Albert M, Ouellet P, Bellemare P, Arsenault P. Preliminary evaluation of a new index to

predict the outcome of a spontaneous breathing trial. Respiratory care. 2011;56(10):1500-5.

Epstein SK. Routine use of weaning predictors: not so fast. Critical care (London ,England). 2009;13(5):197.

Todorova L, Temelkov A. Weaning from long-term mechanical ventilation: a nonpulmonary weaning index.

Journal of clinical monitoring and computin 2004 ;18(4):275-81.

Xy FO, Cai YY, Nu SF. [Drive-time constant (DTC): a new index of respiratory muscle endurance]. Zhonghua yi

xue za zhi. 1993;73(1):29-31, 62.

Hussein K, Hasan AA. Proportional assist ventilation versus conventional synchronized intermittent mandatory

ventilation in chronic obstructive pulmonary disease. Egyptian Journal of Chest Diseases and Tuberculosis.

;63(4):987-94.

MacIntyre NR. Evidence-Based Guidelines for Weaning and Discontinuing Ventilatory SupportA Collective

Task Force Facilitated by the American College of Chest Physicians; the American Association for Respiratory Care;

and the American College of Critical Care Medicine. CHEST Journal. 2001;120(6_suppl):375S-96S.

Vassilakopoulos T, Zakynthinos S, Roussos C. The tension–time index and the frequency/tidal volume ratio are

the major pathophysiologic determinants of weaning failure and success. American journal of respiratory and critical

care medicine. 1998;158(2):378-85.

El Khoury MY, Panos RJ, Ying J, Almoosa KF. Value of the PaO2 / FiO2 ratio and Rapid Shallow Breathing

Index in predicting successful extubation in hypoxemic respiratory failure. Heart & Lung: The Journal of Acute and

Critical Care. 2010;39(6):529-36.

Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the

Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational

studies. Preventive medicine. 2007;45(4):247-51.

Hanley JA, McNeil BJ. A method of comparing the areas under receiver operating characteristic curves derived

from the same cases. Radiology. 1983;148(3):839-43


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