Multivariate analysis on weaning from mechanical ventilation in organophosphate poisoning patients with intermediate syndrome

doi:10.3969/j.issn.1002-1949.2014.09.007

Abstract：Objective To analyze relevant factors on weaning from mechanical ventilation in patients with intermediate syndrome ( IMS) of acute organophosphate poisoning ( AOPP) , and to provide the basis of the time of weaning .Methods Eighty cases with IMS of AOPP in our hospital from September 2005 to July 2012 were included in this retrospective study .They were given combined treatment (gastric lavage, atropine, pralidoxime, chloride, anti -infection, respiratory support and so on) and were divided into two groups:the weaning group and the weaning failure group .Contribution of the factors to prognosis was determined by multivariate analysis with Logistic regression .Results There were 66 cases in the weaning grope , 14 cases in the weaning failure grope .There were significant differences between the weaning group and the weaning failure group , including time window of poisoning (P=0.001) and APACHEⅡ (P=0.001).There were also significant differences in WBC (P=0.032), CK (P=0.001) and CK -MB (P=0.001).The ChE activity of the weaning group was apparently higher than the weaning failure group ( P =0.004 ).There were significant differencesbetween two groups in pulmonary infection (P=0.036), the average dose of pralidoxime chloride (P=0.026), hemoperfusion time (P=0.04) and the dose of atropine (P=0.001).High level of CK was independent predictors of fatality in weaning grope;high level of ChE activity and enough hemoperfusion were protective factors . Conclusion In the base of comprehensive treatment , using full of hemoperfusion , enhancing the administration of airway to decrease pulmonary infection , the APACHEⅡscore of admission, ChE activity and CK , WBC before weaning are helpful to successful weaning from ventilator for AOPP.