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Date Published: 23/12/2024
Abstract Views: 35
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DOI: https://doi.org/10.51298/vmj.v545i3.12363
Issue
Vol. 545 No. 3 (2024)
Section
Các bài báo
How to Cite
Đỗ, N. S., Nguyễn, Đức M., & Đặng, Q. T. (2024). PREDICTORS OF SUCCESSFUL WEANING BY THE INTELLIVENT ADAPTIVE VENTILATION MODE ON PATIENTS WITH THE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE. Vietnam Medical Journal, 545(3). https://doi.org/10.51298/vmj.v545i3.12363

PREDICTORS OF SUCCESSFUL WEANING BY THE INTELLIVENT ADAPTIVE VENTILATION MODE ON PATIENTS WITH THE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Ngọc Sơn Đỗ, Đức Mạnh Nguyễn, Quốc Tuấn Đặng

Main Article Content

Abstract

Objective: To identity predictive factors for successful weaning by the Intellivent adaptive support  ventilation mode (iASV) on patients with the exacerbation of chronic obstructive pulmonary disease (COPD). Subjects and Methods: A prospective observational study was carried out on 20 invasive ventilated patients with COPD exacerbations admitted to the Center for Critical care medicine of Bach Mai Hospital from September 2023 to September 2024. The main variables such as blood gas indices: pH, PaCO2, PaO2, HCO3-, PaO2/FiO2, lactate, vital signs parameters: heart rate, blood pressure, respiratory rate, SpO2 were collected at the timelines: admission, 30 minutes, 60 minutes, 120 minutes after iASV, before extubation and after extubation. Patients were considered as successful weaning if they were not re-intubated after 48 hours. Results: Among 20 patients (mean age 71 ± 9.1 years; 100% men), 16 (80%) patients with successful tracheal extubation. In the failure group, the heart rate, respiratory rate, pH, PaCO2, lactate gradually increased, pH gradually decreased, the most significant difference was before extubation or before switching back to continuous mandatory ventilation with p < 0.05. Factors associated with weaning failure from MV: RSBI (OR = 1.148; CI 1.002-1.316), heart rate (OR = 1.181; CI 1.004-1.389), APACHE II score (OR = 3.074; CI 1.025-9.215), PaCO2 after SBT (OR= 1.135; CI 1.002-1.286). Conclusions: RSBI, heart rate, APACHE II on admission, PaCO2 after SBT can predict the successful extubation. In addition, changes in the heart rate, respiratory rate, pH, PaCO2 can also predict for successful weaning.

Article Details

Keywords

iASV (Intellivent Adaptive Support Ventilation), Exacerbation of COPD, Weaning ventilation.

References

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