A Randomized Controlled Clinical Trial Investigating the Weaning Process From Mechanical Ventilation in Elderly Patients With Dementia

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal Pub Date : 2024-07-16 DOI:10.1111/crj.13808

Jian-Feng Liang, Zhi-Yong Li, Hai-Shan Dong, Chang Xu, Chao-Qun Yin

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引用次数: 0

Abstract

Background

Limited data is available regarding the weaning techniques employed for mechanical ventilation (MV) in elderly patients with dementia in China.

Objective

The primary objective of this study is to investigate diverse weaning methods in relation to the prognostic outcomes of elderly patients with dementia undergoing MV in the intensive care unit (ICU). Specifically, we seek to compare the prognosis, likelihood of successful withdrawal from MV, and the length of stay (LOS) in the ICU.

Methods

The study was conducted as a randomized controlled trial, encompassing a group of 169 elderly patients aged ≥ 65 years with dementia who underwent MV. Three distinct weaning methods were used for MV cessation, namely, the tapering parameter, spontaneous breathing trial (SBT), and SmartCare (Dräger, Germany).

Results

In the tapering parameter group, the LOS in the ICU was notably prolonged compared to both the SBT and SmartCare groups. However, no statistically significant differences were observed among the groups with respect to demographic characteristics, such as age and sex, as well as factors including the rationale for ICU admission, cause of MV, MV mode, oxygenation index, hemoglobin levels, albumin levels, ejection fraction, sedation and analgesia practices, tracheotomy, duration of MV, successful extubation, successful weaning, incidences of ventilator-associated pneumonia, and overall prognosis.

Conclusions

Both the SBT and SmartCare withdrawal methods demonstrated a reduction in the duration of MV and LOS in the ICU when compared to the tapering parameter method.

Trial Registration

Chinese Clinical Trial Registry: ChiCTR1900028449

Abstract Image

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研究老年痴呆症患者机械通气断奶过程的随机对照临床试验

背景关于中国老年痴呆症患者机械通气（MV）断流技术的数据有限：本研究的主要目的是调查在重症监护室（ICU）接受机械通气治疗的老年痴呆症患者的不同断流方法与预后结果的关系。具体而言，我们试图比较预后、成功退出 MV 的可能性以及在重症监护室的住院时间（LOS）：研究以随机对照试验的形式进行，169 名年龄≥ 65 岁的老年痴呆症患者接受了 MV 治疗。研究采用了三种不同的停用中压方法，即渐减参数、自主呼吸试验（SBT）和 SmartCare（德国 Dräger）：结果：与 SBT 组和 SmartCare 组相比，减量参数组患者在重症监护室的住院时间明显延长。然而，在人口统计学特征（如年龄和性别）、入住 ICU 的原因、中风原因、中风模式、氧合作用指数、血红蛋白水平、白蛋白水平、射血分数、镇静和镇痛方法、气管切开术、中风持续时间、成功拔管、成功断奶、呼吸机相关肺炎发病率和总体预后等因素方面，各组间未观察到明显差异：结论：与减量参数法相比，SBT 和 SmartCare 拔管法均可缩短中压持续时间和重症监护室的住院时间：中国临床试验注册中心ChiCTR1900028449。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Respiratory Journal 医学-呼吸系统

CiteScore

3.70

自引率

0.00%

发文量

104

审稿时长

>12 weeks

期刊介绍： Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)