Differences between prolonged weaning patients from medical and surgical intensive care units

被引:0
|
作者
Bickenbach, J. [1 ]
Marx, G. [1 ]
Schmoor, C. [2 ]
Lemmen, S. [3 ]
Marx, N. [4 ]
Dreher, M. [4 ]
机构
[1] Univ Hosp RWTH Aachen, Dept Surg Intens Care, Aachen, Germany
[2] Univ Freiburg, Clin Trials Unit, Med Ctr, Freiburg, Germany
[3] Univ Hosp RWTH Aachen, Dept Infect Control & Infect Dis, Aachen, Germany
[4] Univ Hosp RWTH Aachen, Dept Cardiol Pneumol Angiol & Intens Care Med, Aachen, Germany
关键词
VENTILATOR-ASSOCIATED PNEUMONIA; MECHANICAL VENTILATION; ACQUIRED HYPERNATREMIA; SEVERE SEPSIS; MORTALITY;
D O I
10.1111/aas.12775
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
BackgroundIt is not clear whether patients entering a specialized, interdisciplinary weaning unit from surgical or medical intensive care units (ICU) distinguish substantially. The purpose of the present study was to assess differences in patients with prolonged weaning being referred from surgical and medical ICU. MethodsData collected from April 2013 to April 2014 was conducted for retrospective analysis. Mortality rates, demographic data, clinical, and microbial differences in 150 patients with prolonged weaning were assessed (80 surgical and 70 medical). ResultsSurgical ICU referrals tended to be older (70.7 11.3 vs. 67.3 +/- 12.3, P = 0.051) and had fewer underlying pulmonary diseases (45% vs. 60%, P = 0.067). Sodium values at the time of referral to the weaning unit were significantly higher in surgical (147.1 +/- 9.6) vs. medical (141.3 +/- 6.7 mmol/l) patients (P < 0.001). Each 10-unit increase in sodium at the time of referral to the weaning unit was associated with a 2.5-day (95% CI -0.4, 5.4; P = 0.09) prolongation of stay in the weaning unit. Although significant differences in microbiological agents from tracheal aspiration were seen, the infection rate on the weaning unit was similar in both groups. There was no difference in weaning unit mortality between surgical and medical ICU patients (18% vs. 23%; P = 0.41). ConclusionFew differences were found between patients being referred to a specialized weaning unit from surgical vs. medical ICUs. Besides differences in microbiological characteristics of tracheal secretions, there were also differences in sodium levels, which appear to influence on treatment duration.
引用
收藏
页码:1270 / 1280
页数:11
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