[The relationships between oxygenation index and prognosis in acute respiratory failure patients treated by invasive mechanical ventilation].

Du-jiao Liu, Qing-liang Xue, Lu-jie Wang, Wei-qiang Chen, Wei Chen, Mei Yu
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Abstract

Objective: To investigate the effect of oxygenation index (PaO(2)/FiO(2)) on patients' prognosis through comparative analyzing the monitoring indicators of acute respiratory failure patients treated by invasive mechanical ventilation.

Methods: Data from 91 acute respiratory failure patients treated by invasive mechanical ventilation in respiration intensive care unit (ICU) of the General Hospital of PLA of Lanzhou from November 2006 to August 2011 were retrospectively analyzed. Patients were divided into survival group (n=55) and death group (n=36) by the outcome, the critical severity scores of the diseases and changes in blood gas analysis during ventilation were compared, and their correlation with prognosis were analyzed.

Results: There were no significant differences in acute physiology and chronic health evaluationIII (APACHEIII) score, multiple organ dysfunction syndrome (MODS) score, acute lung injury (ALI) score between survival and death group before ventilation (62.77±22.92 vs. 74.62±25.77, 6.46±2.45 vs. 6.62±3.03, 1.90±0.57 vs. 2.10±0.73, all P>0.05). There was no significant difference in PaO(2)/FiO(2) between survival and death group on the first day of mechanical ventilation (132.18±67.29 mm Hg vs. 139.24±78.36 mm Hg, P>0.05). PaO(2)/FiO(2) in survival group were significantly higher than that in death group on the 3 days and 7 days of mechanical ventilation (3 days: 205.47±74.71 mm Hg vs. 149.76±70.38 mm Hg, 7 days: 225.37±67.20 mm Hg vs. 120.94±85.58 mm Hg, P<0.05 and P<0.01).

Conclusions: The present study demonstrated that the level of PaO(2)/FiO(2) is related with the prognosis of acute respiratory failure patients treated by invasive mechanical ventilation. Continuously monitoring the changes in PaO(2)/FiO(2) can be used as an important reference index to evaluate the prognosis of critical patients.

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有创机械通气治疗急性呼吸衰竭患者氧合指数与预后的关系
目的:通过对急性呼吸衰竭患者有创机械通气监测指标的对比分析,探讨氧合指数(PaO(2)/FiO(2))对患者预后的影响。方法:回顾性分析2006年11月至2011年8月在兰州解放军总医院呼吸重症监护病房(ICU)接受有创机械通气治疗的91例急性呼吸衰竭患者的资料。将患者按转归分为生存组(55例)和死亡组(36例),比较两组患者疾病危重程度评分及通气时血气分析变化,并分析其与预后的相关性。结果:生存组与死亡组患者通气前急性生理与慢性健康评估iii (APACHEIII)评分、多器官功能障碍综合征(MODS)评分、急性肺损伤(ALI)评分差异无统计学意义(62.77±22.92∶74.62±25.77、6.46±2.45∶6.62±3.03、1.90±0.57∶2.10±0.73,均P>0.05)。生存组与死亡组在机械通气第1天PaO(2)/FiO(2)比较差异无统计学意义(132.18±67.29 mm Hg vs 139.24±78.36 mm Hg, P>0.05)。生存组在机械通气第3天和第7天PaO(2)/FiO(2)明显高于死亡组(3天:205.47±74.71 mm Hg vs. 149.76±70.38 mm Hg, 7天:225.37±67.20 mm Hg vs. 120.94±85.58 mm Hg)。结论:本研究表明PaO(2)/FiO(2)水平与有创机械通气治疗急性呼吸衰竭患者的预后有关。持续监测PaO(2)/FiO(2)的变化可作为评价危重患者预后的重要参考指标。
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