The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

IMPORTANCE OF TRACHEOSTOMY TO THE WEANING SUCCESS IN PATIENTS WITH CONSCIOUS DISTURBANCE IN RESPIRATORY CARE CENTER

Yu-Chan Lee1,2, Cheng-Deng Kuo2, Chia-Lin Hsu1, Huey-Dong Wu1, Hao-Chien Wang1; 1National Taiwan University Hospital, Taipei, Taiwan; 2National Yang-Ming University, Taipei, Taiwan

Background: Extubation is particularly controversial in patients with depressed mental status. Using the cutoff of Glasgow coma scale (GCS) >= 8, favored by many investigators, is questionable. Patients and Results: We enrolled a total of 138 consecutive patients (90 of male patients; age: 71±17 years) who were admitted to Respiratory Care Center (RCC) of our hospital from Oct 2009 to Mar 2010. Effects of coma scale on the patients’ outcomes and weaning rate were evaluated. The results showed the mortality rate was significantly higher in patients of RCC with GCS < 7t (p=0.04) or derivate GCS <10 (p<0.05). There were more, but insignificantly, patients with high GCS (GCS >= 7t or derivate GCS >=10) undergoing tracheostomy than those who with low GCS. Moreover, in patients with low GCS (GCS< 7t or derivate GCS <10), the weaning successful rate was significantly higher in patients with tracheostomy than patients without tracheostomy (GCS: 92.9% vs. 36.4%, p=0.004; or derivate GCS: 93.3% vs. 36.4%, p=0.003). But in patients with high GCS, the tracheostomy did not affect the weaning successful rate (p=NS). Conclusions: Consciousness grading by GCS did affect the outcomes in patients of our RCC. Tracheostomy affected the weaning successful rate of patients with low GCS. The low tracheostomy rate in patients with low GCS affected the weaning rate, which may contribute to the higher mortality in patients of RCC. Sponsored Research - None