Influencing factor of mechanical ventilation time in patients with chronic obstructive pulmonary disease / 中华急诊医学杂志

ABSTRACT

Objective To study influencing factor of mechanical ventilation (MV) time in patients withchronic obstructive pulmonary disease (COPD). Method Totally 128 patients with COPD and respiratory failurerequiting ventilation support were retrespectively investigated. The clinical characteristics of patients before and af-ter intuhation during the respiratory intensive care unit (RICU) stay were recorded and analyzed, t- test, X2 testand stepwise logistic regression analysis were used for statistical analysis. Results In the 128 patients, 61%,20%, and 9% of the patients required MV longer than 7, 14 and 21 days, respectively. There were no significantdifferences in the history of COPD, smoking, lung function, and complications between patients with MV>7 d, 14d, 21 d and patients with MV<7 d, 14 d, 21 d. Multiple regression analysis showed APACHE Ⅱ score (OR2.3; 95% Ca 1.2-5.7, P = 0.02) was an independent factor for MV > 7 days, while shock (OR 0.7;95% CI 1.0-1.9, P = 0.04) and decreased serum albumin (OR 0.4, 95% CI 0.2-0.8, P = 0.003)were an independent factors for MV > 21 days. The ventilator-associated pneumonia (VAP) was the most impor-rant risk factor for the time of MV. Conclusions APACHE Ⅱ score, serum albumin levels, hock and VAP arethe main factors affecting MV time in patients with COPD.