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首页> 外文期刊>Canadian Respiratory Journal >Variation of Risk Factors for Cause-Specific Reintubation: A Preliminary Study
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Variation of Risk Factors for Cause-Specific Reintubation: A Preliminary Study

机译：特定原因引起的插管风险因素的变化：初步研究

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Unexpected reintubation may occur, even if the risk factors are considered and a spontaneous breathing trial is successful. Reintubation is thought to be caused by various factors. Several studies have investigated the risk factors of reintubation, but most did not classify reintubation by cause. We retrospectively classified patients undergoing reintubation at intensive care unit by cause (respiratory insufficiency vs. nonrespiratory insufficiency) to examine the cause-specific risk factors of reintubation. A total of 262 patients were included; reintubation within 48 hours after extubation was performed in 12 patients (reintubation rate, 4.5%). After classification by cause of reintubation, the pressure of arterial oxygen to fractional inspired oxygen concentration (P/F) ratio exhibited a significant association with reintubation only in the respiratory insufficiency group (odds ratio (OR) 0.989, 95% confidence interval (CI) 0.980 to 0.999, , and OR 0.989, 95% CI 0.979 to 0.999, , in the univariate and multivariate analyses, respectively). In the propensity score analysis, a P/F ratio ≤ 200 may be a risk factor for reintubation in the respiratory insufficiency group (OR 7.811, 95% CI 1.345 to 45.367, ). In the nonrespiratory insufficiency group, intubation duration was significantly related to reintubation (OR 1.165, 95% CI 1.012 to 1.342, , and OR 1.163, 95% CI 1.004 to 1.348, , in the univariate and multivariate analyses, respectively). In conclusion, a low P/F ratio at extubation may be a risk factor for reintubation due to respiratory insufficiency. In the nonrespiratory insufficiency group, intubation duration may be significantly related to reintubation. The risk factors for reintubation may differ by the cause of reintubation. Further large-scale randomized controlled trials are required.
机译：即使考虑了危险因素并且成功进行了自主呼吸试验，也可能发生意外的再插管。重新插管被认为是由多种因素引起的。有几项研究调查了再插管的危险因素，但大多数研究没有按原因对再插管进行分类。我们根据病因（呼吸功能不全与非呼吸功能不全）对在重症监护病房接受再次插管的患者进行回顾性分类，以研究特定原因的重新插管危险因素。总共262例患者被纳入研究。 12例患者在拔管后48小时内再次插管（插管率4.5％）。根据再插管的原因进行分类后，仅在呼吸功能不全组中，动脉血压与吸入氧气分数（P / F）的比率才与再插管显着相关（比值（OR）0.989，95％置信区间（CI）单变量和多变量分析分别为0.980至0.999和95％CI为0.979至0.999。在倾向评分分析中，P / F≤200可能是呼吸功能不全组再次插管的危险因素（OR 7.811，95％CI 1.345至45.367，）。在非呼吸功能不全组中，插管持续时间与再插管显着相关（在单变量和多变量分析中，OR分别为1.165、95％CI 1.012至1.342和OR 1.163、95％CI 1.004至1.348）。总之，由于呼吸功能不全，拔管时低的P / F比可能是再次插管的危险因素。在非呼吸功能不全组中，插管持续时间可能与再插管显着相关。重新插管的风险因素可能因重新插管的原因而有所不同。需要进一步的大规模随机对照试验。

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