人工气道拔除的影响因素和预测指标_West China Medical Journal

Authors：

 刘婷婷 ,  康焰

四川大学华西医院重症医学科（成都，610041）;

Corresponding author：

康焰, Email: kangyan@vip.sina.com

Keywords：

人工气道拔除; 影响因素; 预测指标

DOI：

10.7507/1002-0179.20140659

Video：

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Abstract Full text Figures/Tables Video References Cited by

人工气道拔除（拔管）是有创通气和人工气道的终点。影响拔管的因素很多，包括病因和各种病理生理因素。在拔除人工气道前，各种影响拔管的因素应得到解决或改善。临床上有许多指标可以帮助医务人员判断影响拔管的各种因素是否得到改善，达到预测拔管成功率的目的。这些指标中一部分已经得到广泛肯定，一部分的意义尚有待证实。当然，医务人员可以进行综合评价和预测。在指标选择上，常用、简单、有效的预测指标则是最佳选择。

Citation： 刘婷婷, 康焰. 人工气道拔除的影响因素和预测指标. West China Medical Journal, 2014, 29(11): 2183-2186. doi: 10.7507/1002-0179.20140659 Copy

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17.	Esteban A, Alía I, Tobin MJ, et al. Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation. Spanish Lung Failure Collaborative Group[J]. Am J Respir Crit Care Med, 1999, 159(2):512-518.
18.	Smailes ST, Mcvicar AJ, Martin R. Cough strength, secretions and extubation outcome in burn patients who have passed a spontaneous breathing trial[J]. Burns, 2013, 39(2):236-242.
19.	Smina M, Salam A, Khamiees M, et al. Cough peak flows and extubation outcomes[J]. Chest, 2003, 124(1):262-268.
20.	Su WL, Chen YH, Chen CW, et al. Involuntary cough strength and extubation outcomes for patients in an ICU[J]. Chest, 2010, 137(4):777-782.
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27.	Rose L, Presneill JJ. Clinical prediction of weaning and extubation in Australian and New Zealand intensive care units[J]. Anaesth Intensive Care, 2011, 39(4):623-629.

1. Frutos-Vivar F, Esteban A, Apezteguia C, et al. Outcome of reintubated patients after scheduled extubation[J]. J Crit Care, 2011, 26(5):502-509.
2. Menon N, Joffe AM, Deem S, et al. Occurrence and complications of tracheal reintubation in critically ill adults[J]. Respir Care, 2012, 57(10):1555-1563.
3. Anderson CD, Bartscher JF, Scripko PD, et al. Neurologic examination and extubation outcome in the neurocritical care unit[J]. Neurocrit Care, 2011, 15(3):490-497.
4. Bilello JF, Davis JW, Cagle KM, et al. Predicting extubation failure in blunt trauma patients with pulmonary contusion[J]. J Trauma Acute Care Surg, 2013, 75(2):229-233.
5. Cheng AC, Cheng KC, Chen CM, et al. The outcome and predictors of failed extubation in intensive care patients:the elderly is an important predictor[J]. Int J Gerontol, 2011, 5(4):206-211.
6. American Association for Respiratory Care. Removal of the endotracheal tube:2007 revision & update[J]. Respir Care, 2007, 52(1):81-93.
7. Salam A, Tilluckdharry L, Amoateng-Adjepong Y, et al. Neurologic status, cough, secretions and extubation outcomes[J]. Intensive Care Med, 2004, 30(7):1334-1339.
8. El Khoury MY, Panos RJ, Ying J, et al. Value of the PaO₂:FiO₂ ratio and Rapid Shallow Breathing Index in predicting successful extubation in hypoxemic respiratory failure[J]. Heart Lung, 2010, 39(6):529-536.
9. Segal LN, Oei E, Oppenheimer BW, et al. Evolution of pattern of breathing during a spontaneous breathing trial predicts successful extubation[J]. Intensive Care Med, 2010, 36(3):487-495.
10. Verceles AC, Diaz-Abad M, Geiger-Brown J, et al. Testing the prognostic value of the rapid shallow breathing index in predicting successful weaning in patients requiring prolonged mechanical ventilation[J]. Heart Lung, 2012, 41(6):546-552.
11. Bruton A. A pilot study to investigate any relationship between sustained maximal inspiratory pressure and extubation outcome[J]. Heart Lung, 2002, 31(2):141-149.
12. Castro AA, Cortopassi F, Sabbag R, et al. Respiratory muscle assessment in predicting extubation outcome in patients with stroke[J]. Arch Bronconeumol, 2012, 48(8):274-279.
13. Fernandez R, Raurich JM, Mut T, et al. Extubation failure:diagnostic value of occlusion pressure (P0.1) and P0.1-derived parameters[J]. Intensive Care Med, 2004, 30(2):234-240.
14. 罗祖金, 詹庆元, 孙兵, 等. 自主呼吸试验的操作与临床应用[J]. 中国呼吸与危重监护杂志, 2006, 5(1):60-62.
15. Su KC, Tsai CC, Chou KT, et al. Spontaneous breathing trial needs to be prolonged in critically ill and older patients requiring mechanical ventilation[J]. J Crit Care, 2012, 27(3):324.e1-324.e7.
16. Wang J, Ma Y, Fang Q. Extubation with or without spontaneous breathing trial[J]. Crit Care Nurse, 2013, 33(6):50-55.
17. Esteban A, Alía I, Tobin MJ, et al. Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation. Spanish Lung Failure Collaborative Group[J]. Am J Respir Crit Care Med, 1999, 159(2):512-518.
18. Smailes ST, Mcvicar AJ, Martin R. Cough strength, secretions and extubation outcome in burn patients who have passed a spontaneous breathing trial[J]. Burns, 2013, 39(2):236-242.
19. Smina M, Salam A, Khamiees M, et al. Cough peak flows and extubation outcomes[J]. Chest, 2003, 124(1):262-268.
20. Su WL, Chen YH, Chen CW, et al. Involuntary cough strength and extubation outcomes for patients in an ICU[J]. Chest, 2010, 137(4):777-782.
21. Khamiees M, Raju P, Degirolamo A, et al. Predictors of extubation outcome in patients who have successfully completed a spontaneous breathing trial[J]. Chest, 2001, 120(4):1262-1270.
22. Tadié JM, Behm E, Lecuyer L, et al. Post-intubation laryngeal injuries and extubation failure:a fiberoptic endoscopic study[J]. Intensive Care Med, 2010, 36(6):991-998.
23. Wittekamp BH, Van Mook WN, Tjan DH, et al. Clinical review:post-extubation laryngeal edema and extubation failure in critically ill adult patients[J]. Crit Care, 2009, 13(6):233.
24. Ochoa ME, Marín Mdel C, Frutos-Vivar F, et al. Cuff-leak test for the diagnosis of upper airway obstruction in adults:a systematic review and meta-analysis[J]. Intensive Care Med, 2009, 35(7):1171-1179.
25. McCaffrey J, Farrell C, Whiting P, et al. Corticosteroids to prevent extubation failure:a systematic review and meta-analysis[J]. Intensive Care Med, 2009, 35(6):977-986.
26. Jaber S, Jung B, Chanques G, et al. Effects of steroids on reintubation and post-extubation stridor in adults:meta-analysis of randomised controlled trials[J]. Crit Care, 2009, 13(2):R49.
27. Rose L, Presneill JJ. Clinical prediction of weaning and extubation in Australian and New Zealand intensive care units[J]. Anaesth Intensive Care, 2011, 39(4):623-629.

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