Depressive disorders during weaning from prolonged mechanical ventilation.
Depressive disorders during weaning from prolonged mechanical ventilation.
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DOI：
10.1007/s00134-010-1842-4
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发表时间：
2010-05
影响因子：
38.9
通讯作者：
Tobin, Martin J.
中科院分区：
文献类型：
--
作者：
Jubran, Amal;Lawm, Gerald;Kelly, Joanne;Duffner, Lisa A.;Gungor, Gokay;Collins, Eileen G.;Lanuza, Dorothy M.;Hoffman, Leslie A.;Tobin, Martin J.
需要机械通气的患者由于完全依赖机器呼吸，因此有情绪紧张的风险。压力可能会对呼吸机脱机和生存产生负面影响。本研究的目的是确定长期机械通气脱机患者的抑郁障碍是否与脱机失败和生存率下降有关。对478例连续患者进行了前瞻性研究，这些患者被转移到长期急性护理医院，以脱离长期通气。临床心理学家进行了精神病学访谈，以评估是否存在抑郁症。在478名患者中，142名患者持续昏迷或谵妄，无法进行抑郁症评估。在其余336例患者中，142例（42%）被诊断为抑郁症。在多变量分析中，共病评分（比值比[OR]，1.23，p=0.007），急性疾病前的功能依赖（OR，1.70，p=0.03）和精神疾病史（OR，3.04，p=0.0001）是抑郁症的独立预测因子。抑郁障碍患者的脱机失败率高于无抑郁障碍患者（61%比33%，p=0.0001），死亡率也是如此（24%比10%，p=0.0008）。抑郁障碍的存在与死亡率独立相关（OR，4.3; p=0.0002）;年龄（OR，1.06; p=0.001）和共病评分（OR，1.24; p=0.02）也预测死亡率。42%脱离长时间通气的患者被诊断为抑郁症。抑郁症患者更有可能经历脱机失败和死亡。
Patients who require mechanical ventilation are at risk of emotional stress because of total dependence on a machine for breathing. The stress may negatively impact ventilator weaning and survival. The purpose of this study was to determine whether depressive disorders in patients being weaned from prolonged mechanical ventilation are linked to weaning failure and decreased survival. A prospective study of 478 consecutive patients transferred to a long-term acute care hospital for weaning from prolonged ventilation was undertaken. A clinical psychologist conducted a psychiatric interview to assess for the presence of depressive disorders. Of the 478 patients, 142 had persistent coma or delirium and were unable to be evaluated for depressive disorders. Of the remaining 336 patients, 142 (42%) were diagnosed with depressive disorders. In multivariate analysis, co-morbidity score (odds ratio [OR], 1.23, p=0.007), functional dependence before the acute illness (OR, 1.70, p=0.03), and history of psychiatric disorders (OR, 3.04, p=0.0001) were independent predictors of depressive disorders. The rate of weaning failure was higher in patients with depressive disorders than in those without such disorders (61% versus 33%, p=0.0001), as was mortality (24% versus 10%, p=0.0008). The presence of depressive disorders was independently associated with mortality (OR, 4.3; p=0.0002); age (OR, 1.06; p=0.001) and co-morbidity score (OR, 1.24; p=0.02) also predicted mortality. Depressive disorders were diagnosed in 42% of patients who are being weaned from prolonged ventilation. Patients with depressive disorders were more likely to experience weaning failure and death.
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影响因子：
8.8
作者：
Pandharipande, P;Shintani, A;Ely, EW
通讯作者：
Ely, EW
影响因子：
8.8
作者：
Douglas, SL;Daly, BJ;Brennan, PF
通讯作者：
Brennan, PF
影响因子：
39.2
作者：
ENGEL, GL
通讯作者：
ENGEL, GL
DOI：
10.1111/j.1532-5415.1991.tb04455.x
发表时间：
1991-09-01
影响因子：
6.3
作者：
KOENIG, HG;MEADOR, KG;BLAZER, DG
通讯作者：
BLAZER, DG
影响因子：
38.9
作者：
Plaschke, Konstanze;Von Haken, Rebecca;Weigand, Markus A.
通讯作者：
Weigand, Markus A.