| Summary: | 碩士 === 長庚大學 === 護理學系 === 100 === The major purposes of this retrospective study were to examine the factors related to early or delayed extubation and the predictors of delayed extubation roups (＞24hrs) in mechanically ventilated patients who were hospitalized in a surgical intensive care unit. Data of 183 intubated patients were retreated and analyzed by descriptive and inferral statistics (Chi-square test or Fisher’s exact test, independent-samples T test, Multiple logistic regression, and Receiver operating characteristic).
The results showed that a total of, 122 patients were in early extubation group whereas 61 patients were in delayed extubation group. The average duration of mechanical ventilation of early extubation group was 0.55 days, whereas 2.99 days in the delayed extubation group. The characteristics of early extubation group were: most of the surgical sites were abdominal (χ2 = 9.97, p = .007); lower APACHE Ⅱ score (12.29±4.75 V.S.14.51±5.10；p=0.004); lower Cumulativ Fluid Balance (CFB) (1324.61±1517.23ml V.S. 2678.90±3469.08ml；p =0.005) and lower Central venous pressure (6.89±3.55mmHg V.S. 8.41±2.75mmHg；p=0.040).
The results of Multiple logistic regression showed that the predictors of delayed extubation groups were: surgical sites, APACHE II, and CFB.
The results of ROC analysis showed that the optimal cut-off values was 13 in APACHE II (sensitivity: 67.2%; specificity: 59.0%). When APACHE II was lowered than 13 points, CFB could not predict the delayed extubation. However, when APACHE II > 13, CFB could predict the delayed extubation and the optimal cutoff point was 1550 c.c. (sensitivity: 68.3%; specificity: 64.6%). These results are valuable in providing high quality of care for extubation patients after surgery.
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