危重症患者机械通气撤机：一项多中心回顾性队列研究方案

Weaning critically ill patients from mechanical ventilation: a protocol from a multicenter retrospective cohort study.

作者信息

Wang Yingzhi, Lei Liming, Yang Huawei, He Songbin, Hao Junhai, Liu Tao, Chen Xingdong, Huang Yongbo, Zhou Jing, Lin Zhimin, Zheng Haichong, Lin Xiaoling, Huang Weixiang, Liu Xiaoqing, Li Yimin, Huang Linxi, Qiu Wenbing, Ru Huangyao, Wang Danni, Wu Jianfeng, Zheng Huifang, Zuo Liuer, Zeng Peiling, Zhong Jian, Rong Yanhui, Fan Min, Li Jianwei, Cai Shaoqing, Kou Qiuye, Liu Enhe, Lin Zhuandi, Cai Jingjing, Yang Hong, Li Fen, Wang Yanhong, Lin Xinfeng, Chen Weitao, Gao Youshan, Huang Shifang, Sang Ling, Xu Yuanda, Zhang Kouxing

机构信息

Department of Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Laboratory of South China Structural Heart Disease, Guangzhou, China.

出版信息

J Thorac Dis. 2022 Jan;14(1):199-206. doi: 10.21037/jtd-21-1217.

DOI:10.21037/jtd-21-1217

PMID:35242382

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8828530/

Abstract

BACKGROUND

Mechanical ventilation (MV) is an important lifesaving method in intensive care unit (ICU). Prolonged MV is associated with ventilator associated pneumonia (VAP) and other complications. However, premature weaning from MV may lead to higher risk of reintubation or mortality. Therefore, timely and safe weaning from MV is important. In addition, identification of the right patient and performing a suitable weaning process is necessary. Although several guidelines about weaning have been reported, compliance with these guidelines is unknown. Therefore, the aim of this study is to explore the variation of weaning in China, associations between initial MV reason and clinical outcomes, and factors associated with weaning strategies using a multicenter cohort.

METHODS

This multicenter retrospective cohort study will be conducted at 17 adult ICUs in China, that included patients who were admitted in this 17 ICUs between October 2020 and February 2021. Patients under 18 years of age and patients without the possibility for weaning will be excluded. The questionnaire information will be registered by a specific clinician in each center who has been evaluated and qualified to carry out the study.

DISCUSSION

In a previous observational study of weaning in 17 ICUs in China, weaning practices varies nationally. Therefore, a multicenter retrospective cohort study is necessary to be conducted to explore the present weaning methods used in China.

TRIAL REGISTRATION

Chinese Clinical Trial Registry (ChiCTR) (No. ChiCTR2100044634).

摘要

背景

机械通气（MV）是重症监护病房（ICU）中一种重要的挽救生命的方法。长时间机械通气与呼吸机相关性肺炎（VAP）及其他并发症相关。然而，过早撤机可能导致再次插管或死亡风险增加。因此，及时、安全地撤机很重要。此外，识别合适的患者并进行适当的撤机过程是必要的。尽管已经报道了一些关于撤机的指南，但对这些指南的依从性尚不清楚。因此，本研究的目的是通过一项多中心队列研究，探讨中国撤机情况的差异、初始机械通气原因与临床结局之间的关联，以及与撤机策略相关的因素。