Strengthening research in mechanical ventilation weaning_Chinese Journal of Respiratory and Critical Care Medicine

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YU Senyang

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mechanical ventilation

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對意外或自主拔管患者的研究顯示，接受完全機械通氣患者的23％和開始撤機過程患者的69％并不需要重新插管，這表明機械通氣患者的撤機存在被延遲的傾向，致使患者承受不必要的痛苦，增加了并發癥的發生率和醫療費用。撤機過程所耗費的時間占機械通氣整個時間的40％~50％。Esteban等的研究證明：延長通氣時間增加病死率。在美國，機械通氣的費用約2 000美元／d，延長通氣者占總機械通氣患者的6％，但卻消耗ICU資源的37％。我國的撤機現狀與之類似，日益增多的撤機困難患者占用各ICU的有限資源，成為醫療費用和床位周轉的沉重負擔。機械通氣撤離的研
究亟待加強。

Citation： YU Senyang. Strengthening research in mechanical ventilation weaning. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(4): 242-244. doi: Copy

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9.	Burns KE，Adhikari NK，Meade MO.A meta-analysis of noninvasive weaning to facilitate liberation from mechanical ventilation.Can J Anesth，2006，53：305-315.
10.	Peter JV，Moran JL，Phillips-Hughes J，et al.Noninvasive ventilation in acute respiratory failure--a meta-analysis update.Crit Care Med，2002，30：555-562.
11.	Tobin MJ，Jubran A.Meta-analysis under the spotlight：focused on a meta-analysis of ventilator weaning.Crit Care Med，2008，36：1-7.

1. Epstein SK，Nevins ML，Chung J.Effect of unplanned extubation on outcome of mechanical ventilation.Am J Respir Crit Care Med，2000，161：1912-1916.
2. Esteban A，Anzueto A，Frutos F，et al．Mechanical ventilation international study group．Characteristics and outcomes in adult patients receiving mechanical ventilation：a 28-day international study．JAMA，2002，287：345-355．.
3. Cooper LM，Linde-Zwirble WT.Medicare intensive care unit use：analysis of incidence，cost，and payment.Crit Care Med，2004，32：2247-2253.
4. Wagner DP.Economics of prolonged mechanical ventilation.Am Rev Respir Dis，1989，140：S14-S18.
5. MacIntyre NR，Cook DJ，Ely EW Jr，et al.Evidence-based guidelines for weaning and discontinuing ventilatory support：a collective task force facilitated by the American College of Chest Physicians；the American Association for Respiratory Care；and the American College of Critical Care Medicine.Chest，2001，120(6 Suppl)：375S-395S.
6. Boles JM，Bion J，Connors A，et al.Weaning from mechanical ventilation.Eur Respir J，2007，29：1033-1056.
7. Saura P，Blanch L，Mestre J，et al.Clinical consequences of the implementation of a weaning protocol.Intensive Care Med，1996，22：1052-1056.
8. Krishnan JA，Moore D，Robeson C，et al.A prospective，controlled trial of a protocol-based strategy to discontinue mechanical ventilation.Am J Respir Crit Care Med，2004，169：673-678.
9. Burns KE，Adhikari NK，Meade MO.A meta-analysis of noninvasive weaning to facilitate liberation from mechanical ventilation.Can J Anesth，2006，53：305-315.
10. Peter JV，Moran JL，Phillips-Hughes J，et al.Noninvasive ventilation in acute respiratory failure--a meta-analysis update.Crit Care Med，2002，30：555-562.
11. Tobin MJ，Jubran A.Meta-analysis under the spotlight：focused on a meta-analysis of ventilator weaning.Crit Care Med，2008，36：1-7.

Chinese Journal of Respiratory and Critical Care Medicine

Strengthening research in mechanical ventilation weaning

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