Patient in the medical intensive care unit of a medical center ventilator weaning and the relevant factors

• Main Authors: YEH MEI-HUA, 葉美華
• Other Authors: Ms.CHEN HUI-FANG
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/3ddt27

碩士 === 嘉南藥理大學 === 醫務管理系 === 107 === When a patient develops respiratory failure or difficulty, a respirator is used clinically to assist the patient in breathing to continue their life. The longer the respirator is used, the more it will increase the complexity of the condition and the risk of death. Therefore, assisting the patient to leave the respirator as soon as possible can reduce the damage caused by using the respirator. The respirator detachment program helps to improve the chance of getting out of the respirator and reduce the burden on the medical manpower. Therefore, this study aims to explore the factors related to the use of the respirator in the respirator to improve the clinical respiratory detachment success rate. The retrospective data of care is analyzed to assess and explore the current respirator detachment plan and serve as a reference for future care plan updates. This study used a retrospective approach to patients who underwent endotracheal intubation and respiratory therapy for respiratory failure during the period from August 1, 2014 to July 31, 2015 in a medical intensive care unit at a medical center in Central China. And analyze the medical records of the use of the respirator in the medical intensive care unit of the medical center during this period. After the merger, a total of 6,506 patient cases were excluded, and the respiratory care center (RCC) had patients who used the respirator, and will be calculated after returning home. The average of all parameters totaled 909 patients. Statistical analysis was performed with SPSS Window 19.0, including frequency, percentage, mean, standard deviation, Chi-square, and Multiple Logistic Regression Analysis. Explore the characteristics of the patient, the mechanical factors of the respirator, the spontaneous breathing index, and the physiological factors of the patient, and the relationship between whether or not to escape from the respirator. The study found that males were mostly (OR=0.356, P<.232), the total number of respirators used was 3-5 days (OR=0.462, P<.351), and the lower the inhaled oxygen fraction (OR=6.213, P< .044) The higher the rate of spontaneous detachment from the respirator for patients with spontaneous maximum inspiratory pressure ≧-30cmH2O (OR=2.472, P<.018). In addition, the lower the inhaled oxygen fraction (OR = 6.213), the total number of monitored respirations > 20 beats / min (OR = 2.472), and the arterial blood gas base excess value > + 2 (OR = 1.061)) There is a strong correlation with successful escape from the respirator. This study showed that the total number of days of sex and respirators used was 3-5 days, and the lower the inhaled oxygen fraction.The spontaneous maximum inspiratory pressure ≧-30cmH2O is a significant factor in the patient's respirator detachment.Clinical respiratory care can provide a place for respiratory therapists to pay attention to; the purpose of the study is to understand the factors related to ventilator detachment, to improve the success rate of clinical respirator detachment, and to develop a respiratory care assessment for future clinical detachment Project.