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博士論文
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DOI[info:doi/10.1186/s40560-018-0313-9]のデータに遷移します
Lung-thorax compliance measured during a spontaneous breathing trial is a good index of extubation failure in the surgical intensive care unit : a retrospective cohort study
- 国立国会図書館永続的識別子
- info:ndljp/pid/11279128
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資料に関する注記
一般注記:
- BackgroundExtubation failure is associated with mortality and morbidity in the intensive care unit. Ventilator weaning protocols have been introduced,...
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デジタル
- 資料種別
- 博士論文
- 著者・編者
- 岡部, 悠吾
- 著者標目
- 出版年月日等
- 2019-03-24
- 出版年(W3CDTF)
- 2019-03-24
- 授与機関名
- 香川大学
- 授与年月日
- 2019-03-24
- 授与年月日(W3CDTF)
- 2019-03-24
- 報告番号
- 甲第707号
- 学位
- 博士(医学)
- 博論授与番号
- 甲第707号
- 本文の言語コード
- eng
- 著者別名
- 件名標目
- 対象利用者
- 一般
- 一般注記
- BackgroundExtubation failure is associated with mortality and morbidity in the intensive care unit. Ventilator weaning protocols have been introduced, and extubation is conducted based on the results of a spontaneous breathing trial. Room for improvement still exists in extubation management, and additional objective indices may improve the safety of the weaning and extubation process. Static lung-thorax compliance reflects lung expansion difficulty that is caused by several conditions, such as atelectasis, fibrosis, and pleural effusion. Nevertheless, it is not used commonly in the weaning and extubation process. In this study, we investigated whether lung-thorax compliance is a good index of extubation failure in adults even when patients pass a spontaneous breathing trial.MethodsIn a single-center, retrospective cohort study, patients over 18 years of age were mechanically ventilated, weaned with proportional assist ventilation, and underwent a spontaneous breathing trial process in surgical intensive care units of Kagawa University Hospital from July 2014 to June 2016. Extubation failure was the outcome measure of the study. We defined extubation failures as when patients were reintubated or underwent non-invasive positive-pressure ventilation within 24 h after extubation. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the clinical involvement of several parameters. The area under the curve (AUC) was calculated to assess the discriminative power of the parameters.ResultsWe analyzed 173 patients and compared the success and failure groups. Most patients (162, 93.6%) were extubated successfully, and extubation failed in 11 patients (6.4%). The averages of lung-thorax compliance values in the success and failure groups were 71.9 ± 23.0 and 43.3 ± 14.6 mL/cmH2O, respectively, and were significantly different (p < 0.0001). In the ROC curve analysis, the AUC was highest for lung-thorax compliance (0.862), followed by the respiratory rate (0.821), rapid shallow breathing index (0.781), Acute Physiology and Chronic Health Evaluation II score (0.72), heart rate (0.715), and tidal volume (0.695).ConclusionsLung-thorax compliance measured during a spontaneous breathing trial is a potential indicator of extubation failure in postoperative patients.
- DOI
- info:doi/10.1186/s40560-018-0313-9
- 国立国会図書館永続的識別子
- info:ndljp/pid/11279128
- コレクション(個別)
- 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
- 収集根拠
- 博士論文(自動収集)
- 受理日(W3CDTF)
- 2019-05-06T10:27:56+09:00
- 作成日(W3CDTF)
- 2020-10-27
- 記録形式(IMT)
- PDF
- オンライン閲覧公開範囲
- 国立国会図書館内限定公開
- デジタル化資料送信
- 図書館・個人送信対象外
- 遠隔複写可否(NDL)
- 可
- 連携機関・データベース
- 国立国会図書館 : 国立国会図書館デジタルコレクション