The Relationship Between Related Factors of Ventilatory Weaning and the Successful Weaning in Patients Undergone Cardiac Surgery

• Main Authors: Yun-Wen Yung, 雍允雯
• Other Authors: Chii Jeng
• Format: Others
• Language: zh-TW
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/83633018464957314944

碩士 === 臺北醫學大學 === 護理學系 === 91 === The purpose of this research was to study the relationship between related factors of ventilatory weaning after cardiac surgery and successful weaning. To understand the most dissatisfied factors of weaning after cardiac surgery by using the weaning indicators after cardiac surgery. In the mean time, we found out the most effective predictors of successful weaning after cardiac surgery. Thus we can provide and develop nursing intervention to improve ventilatory weaning after cardiac surgery. An explored-correlated crossectional design was used. This research collected 121 cases of post-cardiac surgical patients and only 115 cases (95%) succeed in ventilatory weaning after cardiac surgery. Data was analyzed by percentage, mean, standard deviation, and frequency, T-test, ANOVA, Chi-Square, Pearson correlation, and Logistic regression. The major findings of this study were as follows:(1)the time interval between post- surgery and the start of weaning is 5.8（±5.4）hours, the time required for weaning was 6.7（±5.2）hours, and the successful weaning time required was 12.4（±7.7）hours.（2）The most dissatisfied factors of preparing weaning were patients’ neurological and musculoskeletal status. The best achieving factors was arterial blood gas. Over 50% of patients failed in 6 items, included 「ear temperature in 36~37.5℃」,「magnesium level in 0.75~1.5 mmol/L」, 「conscious clear，Ramsay Scale about 2~3 scores」,「hands elevat high and feet above the bed for 3-5 centimeters」,「sufficient sleep/ rest」and「no dyspnea」.（3）The dose of muscle relaxant（pavulon） used in operation was positive related to the time required from the post-operation till the start of weaning（r=0.24，p=0.01）and also time required from post-operation till successful weaning（r=0.20，p=0.03）.Using cardiopulmonary bypass machine or not during cardiac operation makes difference on the time of ventilator using after surgery. The weaning time required was significantly correlated to blood hemodynamic data（r= - 0.22，p=0.02）and the score of weaning protocol assessment（r=- 0.23，p = 0.02）；（4）The significant predictors of successful weaning in 4 hours after surgery were the usage of CPB machine or not and the weaning parameter. The significant predictors of successful weaning in 8 hours after surgery included the usage of CPB machine or not, the blood gas data, and the electrolytes and clinical laboratory data。The result of this study would be valuable in quality of care of ventilatory weaning after surgery. Key word： ventilatory weaning, weaning indicators