呼吸浅快指数和气道闭合压对严重创伤患者撤机的预测价值

The predictive value of rapid shallow breathing index and airway occlusion pressure in severe trauma

目的评估呼吸浅快指数(RSBI)和气道闭合压(P0.1)对预测因呼吸衰竭(RF)行机械通气(MV)的严重创伤患者撤机成功与否的价值。方法选取机械通气48小时以上且已达到撤机标准的74例严重创伤患者,行自主呼吸试验2小时,在自主呼吸试验进行30min时检测浅快指数(RSBI)和气道闭合压(P0.1)值,探讨它们在严重创伤患者撤机中的预测价值。结果 61例严重创伤患者撤机成功,13例失败。成功组患者的P0.1和RSBI值明显小于失败组,其差异均具有显著统计学意义(P<0.05)。P0.1预测严重创伤患者撤机的价值优于RSBI,灵敏度、特异度和准确性分别为93.5%、75.0%和95.1%。结论 P0.1和RSBI对严重创伤患者的撤机均具有指导意义,其中P0.1的价值更大。

Objective To evaluate the predictive value of rapid shallow breathing index （RSBI） and airway occlu- sion pressure （P0.1） predicting the outcome of weaning from mechanical ventilation in severe trauma with respiratory fail- ure （RF）. Methods 74 patients with severe trauma after mechanical ventilation for at least 48 hours ready for weaning were enrolled. All patient accepted 2 hours spontaneous breathing trial. The airway occlusion pressure （P0.1） ,rapid shal- low breathing index （RSBI） were detected at 30 minutes after spontaneous breathing trial. The clinical value of P0.1 and RSBI index for prognosis of successful ＂weaning from severe trauma patients were assessed. Results 61 patients were successfully weaned from ventilation, and 13 patients were difficulty weaned from ventilation （P0.1）. RSBI in weaning Suc- cess group were lower than those in weaning failure group（P〈0.5）. P0.1 was superior to RSBI in predicting weaning out- comes from severe trauma patients. The sensitive rate was 93.5%, the specific rate was 75.0% and the accurate rate was 95.1%, which were higher than that of RSBI. Conclusion The RSBI and P0.1 are valuable predictor for the patients with severe trauma to wean from mechanical ventilation, and the predicting value of P0.1 is superior to RSBI.