Factors Associated with Ventilator Weaning in Intubated Patients of Offshore Islands in Taiwan

• Main Authors: CHEN,CHUN-YU, 陳俊宇
• Other Authors: Liang, Shu-Yuan
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/8q8k45

碩士 === 國立臺北護理健康大學 === 護理研究所 === 106 === Background: The successful weaning of ventilator has always been an important challenge. There are many factors that affect the ventilator weaning. Clinically, the indicators of disengagement are not completely different. Ventilator weaning are not 100% successful. Ventilator weaning of the predictive indicators to increase other predictive projects, a comprehensive assessment of the patient's physical preparation, we can more accurately grasp the timing of ventilator weaning. Poupose: To investigate Pimax, RSBI, cuff-leak volume, grip strength and ventilator weaning, and predictors of successful weaning. Methods: We used a cross-sectional design with convenience sampling. A total of 60 patients were recruited from ICU in teaching hospitals in a certain island. Data were collected with medical record review and measurement tools, and t test, Mann-Whitney U test, Chi-Square test, and Logistic Regression were used to analyze data. Results: The results of study showed significant differences in ventilator weaning results at BMI (t=-3.47, p=0.001), ICU stay (Z=-2.49, p=0.013), APACHE II at admission (Z=-2.76, p=0.006) and before weaning (t=2.83, p=0.006), breathing sound (p=0.004), HCO3- (t=2.28, p=0.026), BE (t=2.65, p=0.010), and Pimax (Z=-2.31, p=0.021). The remaining variables in ventilator weaning results are not significantly different. The best predictor of successful weaning was BMI, with 80.0% Accuracy, 95.7% sensitivity, 28.6% specificity, 81.5% PPV, and 66.7% NPV. The combined of BMI, ICU stay, and APACHE II before weaning increased to 85.0% Accuracy, 93.5% sensitivity, 57.1% specificity, 87.8% PPV, and 72.7% NPV. Conclusion: BMI, ICU stay, and APACHE II before weaning determine the outcome of intubated patient ventilator weaning.