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    Please use this identifier to cite or link to this item: https://ir.cnu.edu.tw/handle/310902800/31766

    標題: Establishing failure predictors for the planned extubation of overweight and obese patients
    作者: Chao, Chien-Ming
    Lai, Chih-Cheng
    Cheng, Ai-Chin
    Chiang, Shyh-Ren
    Liu, Wei-Lun
    Ho, Chung-Han
    Hsing, Shu-Chen
    Chen, Chin-Ming
    Cheng, Kuo-Chen
    貢獻者: Chi Mei Med Ctr, Dept Intens Care Med
    Chi Mei Med Ctr, Dept Internal Med
    Chia Nan Univ Pharm & Sci
    Chi Mei Med Ctr, Dept Med Res
    Chi Mei Med Ctr, Dept Intens Care Med
    Chung Hwa Univ Med Technol, Dept Safety Hlth & Environm Engn
    關鍵字: Intensive-Care-Unit
    Spontaneous Breathing Trial
    Mechanical Ventilation
    Bariatric Surgery
    日期: 2017-08-16
    上傳時間: 2018-11-30 15:55:54 (UTC+8)
    出版者: Public Library Science
    摘要: We investigated failure predictors for the planned extubation of overweight (body mass index [BMI] = 25.0-29.9) and obese (BMI >= 30) patients. All patients admitted to the adult intensive care unit (ICU) of a tertiary hospital in Taiwan were identified. They had all undergone endotracheal intubation for > 48 h and were candidates for extubation. During the study, 595 patients (overweight = 458 [77%]); obese = 137 [23%]) with planned extubation after weaning were included in the analysis; extubation failed in 34 patients (5.7%). Their mean BMI was 28.5 +/- 3.8. Only BMI and age were significantly different between overweight and obese patients. The mortality rate for ICU patients was 0.8%, and 2.9% for inpatients during days 1-28; the overall in- hospital mortality rate was 8.4%. Failed Extubation group patients were significantly older, had more end- stage renal disease (ESRD), more cardiovascular system- related respiratory failure, higher maximal inspiratory pressure (MIP), lower maximal expiratory pressure (MEP), higher blood urea nitrogen, and higher ICU- and 28-day mortality rates than did the Successful Extubation group. Multivariate logistic regression showed that cardiovascular- related respiratory failure (odds ratio [OR]: 2.60; 95% [confidence interval] CI: 1.16-5.80), ESRD (OR: 14.00; 95% CI: 6.25-31.35), and MIP levels (OR: 0.94; 95% CI: 0.90-0.97) were associated with extubation failure. We conclude that the extubation failure risk in overweight and obese patients was associated with cardiovascular system- related respiratory failure, ESRD, and low MIP levels.
    關聯: Plos One, v.12, n.8, e0183360
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