无创通气降低腹部手术后呼吸衰竭患者气管再插管风险的研究

doi:10.3969/j.issn.1002-1949.2017.11.010

Chinese Journal of Critical Care Medicine

2017, Vol. 37

Issue (11): 1011-1015 DOI: 10.3969/j.issn.1002-1949.2017.11.010

Risk of reducing endotracheal reintubation in patients with respiratory failure after abdominal surgery by noninvasive ventilation

Dong Hong, Qian Qin-juan, Zhang Ying, Fei Zhi-yong, Kang Zhen

Department of Respiratory and Critical Care Medicine, Tianjin Haibin People′s Hospital, Tianjin 300280, China

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Abstract Objective: To evaluate the effect of noninvasive ventilation (NIV) on endotracheal reintubation in patients with hypoxic respiratory failure after abdominal surgery. Methods: The patients with hypoxic respiratory failure within 7 days after abdominal surgery in our hospital ICU were randomly divided into two groups according to the random number table method. The patients were treated with NIV (NIV group, n=173) treatment or standard oxygen treatment (standard oxygen therapy group, n=175). The treatment was performed for 30 days from completion of randomization, or to leave ICU. The endotracheal reintubation rate, noninvasive ventilation time, treatment-related infection and mortality were compared between the two groups. Results: The number of patients endotracheal re-intubated in the NIV group was significantly lower than that in the standard oxygen therapy group ［57(32.9%) vs. 80 (45.7%), χ2=5.940, P=0.015］. Compared with the standard oxygen therapy group, the NIV group had no significant improvement in noninvasive ventilation time ［(25.5±4.2) d vs. (20.6±3.8) d, t=11.415, P＜0.001］. The patients in the NIV group had fewer infections［54(31.2%) vs. 86(49.1%), χ2=11.630, P<0.001］. The patients in group NIV had fewer patients with pneumonia within 7 days ［17 (9.8%) vs. 39 (22.3%), χ2=10.002, P=0.002］ and 30 days ［25 (14.5%) vs. 52 (29.7%), χ2=11.763, P<0.001］. There was no statistically significant difference in ICU hospitalization time between the two groups (P>0.05). Multivariate analysis showed that NIV was negatively correlated with endotracheal reintubation (OR=0.496, 95% CI 0.231～0.817, P=0.007). Conclusion: Noninvasive ventilation can reduce the risk of endotracheal reintubation in patients with hypoxic respiratory failure after abdominal surgery compared with standard oxygen therapy.

Received: 18 June 2017

About author:: Dong Hong, E-mail: donghongtjhb@sina.com

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Dong Hong,Qian Qin-juan,Zhang Ying, et al. Risk of reducing endotracheal reintubation in patients with respiratory failure after abdominal surgery by noninvasive ventilation[J]. Chinese Journal of Critical Care Medicine, 2017, 37(11): 1011-1015.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2017.11.010 OR http://www.cnemergency.org.cn/EN/Y2017/V37/I11/1011

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