Predictive factors for choosing the ventilation mode at the early stage of adult respiratory distress syndrome
Abstract：Objective To evaluate the predicting factors on the change of ventilation mode for patients with adult respiratory distress syndrome ( ARDS) .Methods To respective analysis the clinical data of 49 patients with ARDS who need change ventilation mode within 24 hours after admission. Twenty-two quantitative indicators and five classification variables was collected for analysis.A classification of patients into invasive or noninvasive groups was based on ventilation mode after 48 hours.Results The death rate at day 7 and day 28 revealed statistical difference among these two subgroups (12 vs 0, 17 vs 3, P<0.05).Statistical differences (P<0.05) were also found at clinical data including whether need vasoactive agent, pulmonary and extra-pulmonary inducement, heart rate, GCS score, APACHEⅡscore, creatinine, lactic acid and platelets.Binomial logistic regression analysis revealed predicting function on change of ventilation mode at the above data but none of them was independent predictors.Receiver -operating characteristic curve calculated the cut off value of 6 quantitative indicators containing APACHEⅡscore>17, GCS score<13, heart rate>123/min, lactic acid >3.6 mmol/L platelets <191 ×109/L and creatinine >66 mmol/L.Conclusion Our investigation confirms 8 predicting factors indicating the lose control of compensatory ability for ARDS patients.In this situation, noninvasive ventilation mode can not match the need of therapy, so change of invasive ventilation mode should been performed as soon as possible.
Keywords：Respiratory support modeAcute respiratory distress syndrome ( ARDS)Invasive ventilationNoninvasive ventilationPredicting factors
Publication Date：2015-01-01
Pages：5( 697-701 )