Effect of hypophosphatemia on weaning success from mechanical ventilation
| Autor: | Muhammet Cemal Kizilarslanoglu, Sabahat Tezcan, Serpil Öcal, Basak Bolayir, Ebru Ortaç Ersoy, Arzu Topeli, Banu Cakir, Atilla Kara |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Lung Diseases Male Pulmonary and Respiratory Medicine Hypophosphatemia medicine.medical_treatment Critical Care and Intensive Care Medicine Risk Factors Odds Ratio Humans Medicine Weaning Prospective Studies Treatment Failure Prospective cohort study Blood urea nitrogen Aged Retrospective Studies Mechanical ventilation business.industry Organ dysfunction Retrospective cohort study Middle Aged medicine.disease Intensive Care Units Case-Control Studies Relative risk Anesthesia Chronic Disease Female Surgery medicine.symptom business Ventilator Weaning |
| Zdroj: | Tuberkuloz ve Toraks. 63:102-108 |
| ISSN: | 0494-1373 |
| DOI: | 10.5578/tt.8119 |
| Popis: | INTRODUCTION Hypophosphatemia may cause acute respiratory failure and tissue hypoxia. In this study we investigated the effect of hypophosphatemia on weaning success. PATIENTS AND METHODS A nested case-control study was conducted in a retrospective cohort of 76 patients who received invasive mechanical ventilation in 2005-2010 in the Medical Intensive Care Unit (MICU) of university hospital. Case patients (failure group) were those who could not be weaned in the first trial or who required post-extubation mechanical ventilation after first extubation. Control patients (success group) were successfully extubated in the first weaning attempt. RESULTS Frequency of hypophosphatemia (P level < 2.5 mg/dL) at admission was 23.7%. Weaning failure rate was 71.1%. Risk of weaning failure in the presence of hypophosphatemia was 88.9%, whereas risk in the absence of hypophosphatemia was 65.5%, resulting in risk ratio of 1.36 (1.06 - 1.74) (p= 0.096). Mean (± SD) P levels in the success and failure groups were 3.6 ± 1.0 and 3.2 ± 1.0 mg/dL, respectively (p= 0.113). Logistic regression analysis revealed four independent risk factors which were presence of underlying chronic pulmonary disease, high organ dysfunction score (SOFA) at admission, high blood urea nitrogen at the day of weaning trial and low P level at admission to predict weaning failure. Each 1 mg/dL increment in P level resulted in decreased probability of weaning failure with an OR of 0.43 (0.21-0.88). CONCLUSION In conclusion, a relation between hypophosphatemia and weaning failure was determined which has to be confirmed with prospective cohort and interventional studies with adequate power. |
| Databáze: | OpenAIRE |
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