The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts


Chin-Jung Liu1,2, Chia-Chen Chu1,2, Wei Chen3, Che-Yi Chou4, Wei-Erh Cheng3, Wen-Miin Liang5, Yi-Heng Liu3, Chuen-Ming Shih1,3

Background: To assess the spontaneous breathing ability of mechanical ventilation patients with the measurement of spontaneous breathing weaning profiles is popular to predicate the success rate in intensive care unit. Are these parameters still useful to predict prolonged ventilation in weaning success rate? And what is the best predictor of weaning indexes in prolonged mechanical ventilation patients?

Materials: and Methods: We retrospectively reviewed all the ventilator dependent patients who accept invasive mechanical ventilation over 10 days, in a respiratory care center (RCC) of China Medical University Hospital, Taichung City, Taiwan. Weaning profile including maximal inspiratory pressures (PImax), maximal expiratory pressures (PEmax), respiratory rate, tidal volume (VT), minute ventilation(VE), and rapid shallow breathing index (RSBI) measured at spontaneous breathing trial weekly were recorded. All of weaning index was measured weekly and analyzed by paired t-test and chi-squire with sex. The weaning outcome was analyzed using Kaplan-Meier analysis by SPSS software.

Results: From 1st April to 31st October 2006, we reviewed 260 (150 men and 110 women) long-term ventilator dependent patients with a mean age of 69.8 ± 15.3 year-old. A total of 116 (44.6%) patients were successfully weaned from mechanical ventilator in 42.05± 16.1 days follow-up. There were significantly differences with duration of mechanical ventilation in all of the weaning profiles. By the trend of weaning profile analyzed by independent t-test were significantly in first 5 weeks. In Kaplan-Meier analyzed the weaning outcome was significantly associated with a successful weaning (p=0.001). We compared each weaning parameter weekly. There are significant difference between weaning successful and ventilator depended in the first, fifth and seventh week with PImax, the fourth and sixth week with PEmax, the third, fourth and fifth week with tidal volume, the first, second, third, fifth and sixth with respiratory rate, the second, fourth, fifth and sixth with RSBI.

Conclusion: Approximately 45% of prolonged mechanical ventilation patients were successfully weaned from mechanical ventilator in 71 days follow-up. PImax, PEmax , respiratory rate, minute volume, tidal volume and rapid shallow breathing index was measured at spontaneous breathing trial weekly is still useful index in prolonged mechanical ventilation patients, so we can't give up any chance to weaning.