Clinical value of PICCO in weaning of mechanical ventilation patients

WANG Chao; WANG Yong-qiang; SUN Jing-jing

doi:10.3969/j.issn.1002-1949.2014.11.017

Abstract：Objective To explore the clinical value of pulse index continuous cardiac output ( PICCO) in weaning of mechanical ventilation patients.Methods We prospectively analyzed the data of 58 cases from Jan, 2013 to Jun, 2013 in our hospital, which were divided into two groups including weaning successful group (n=38) and weaning failure group (n=20).Extravascular lung water index ( EVLWI) , global end diastolic volume index ( GEDVI) , intra-thoracic blood volume index ( ITBVI) , pulmonary vascular permeability index ( PVPI) were monitored by PICCO at the time points including 15 min before weaning, 15 min after weaning, 30 min after weaning, and 48 hours after weaning or reintubation.Results The APACHEⅡscore, the duration of ventilator and Cr value of weaning failure group were higher than weaning successful group (P <0.05), and the ALB value was lower than weaning successful group (P<0.05).There were no statistic differences between the two groups when before and after weaning 15 min (P>0.05).After weaning 30 min the GEDVI and ITBVI of weaning failure group were higher than which of weaning successful group ( t values were -3.261, -3.828, P<0.01).Also after weaning 48 hours or reintubation the EVLWI, GEDVI, ITBVI and PVPI of weaning failure group were higher than which weaning successful group ( t values were -8.788,-4.668, -4.270, -6.884, P<0.01).Conclusion The PICCO monitoring benefits early diagnosis of pulmonary edema induced by weaning, which provides reliable instructions for clinical use.