Changes in B-type natriuretic peptide improve weaning outcome predicted by spontaneous breathing trial
Changes in B-type natriuretic peptide improve weaning outcome predicted by spontaneous breathing trial
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DOI：
10.1097/ccm.0b013e31816f49ac
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发表时间：
2008-05-01
影响因子：
8.8
通讯作者：
Yang, Pan-Chyr
中科院分区：
文献类型：
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作者：
Chien, Jung-Yien;Lin, Mao-Shin;Yang, Pan-Chyr
Objective.尽管使用自主呼吸试验（SBT），预测脱机成功仍然是一个主要的临床挑战。由于心血管功能障碍可能是一个主要的潜在机制的脱机失败，我们评估的作用，B型利钠肽（BNP），心血管功能的标志物，在患者谁通过了2小时SBT.Design，设置，和患者的水平：52例急性呼吸衰竭恢复作为测试组，以确定BNP的预测价值。BNP的预测价值在第二个独立队列的49例患者中得到验证。结果：实验组52例，41例通过SBT，拔管。在这些患者中，33例患者（80%）成功拔管（拔管成功），8例患者（20%）在48小时内重新插管（拔管失败）。基线BNIP水平无差异，但拔管失败组在SBT结束时BNP水平显著高于拔管成功组（32.7%，第25 - 75百分位数= 25.7%-50.8% vs. 0.69%，-8.8%-10.72%，p
Objective. Despite the use of spontaneous breathing trial (SBT), predicting weaning success remains a major clinical challenge. Because cardiovascular dysfunction could be a major underlying mechanism of weaning failure, we evaluated the role of the levels of B-type natriuretic peptide (BNP), a marker for cardiovascular function, in patients who passed a 2-hr SBT.Design, Setting, and Patients: Fifty-two patients recovering from acute respiratory failure were enrolled as the testing group to determine the predictive value of BNP. The predictive value of BNP was validated in a second independent cohort of 49 patients. Then, we combined both groups of patients to conduct the final analysis.Measurements and Results: In the testing group of 52 patients, 41 passed SBT and were extubated. Of these patients, 33 patients (80%) were extubated successfully (extubation success) while eight patients (20%) were reintubated within 48 hrs (extubation failure). There were no differences in the baseline BNIP levels, but the extubation failure group had significantly greater increases in BNP at the end of SBT than the extubation success groups (32.7%, 25(th)-75(th) percentile = 25.7%-50.8% vs. 0.69%, -8.8%-10.72%, p