A Study on the Analysis of Recurrent Respiratory Failure in Prolonged Mechanical Ventilation Patient who Receive Different Aritificial Airway — A Case Study of Chronic Obstructive Pulmonary Disease Patients

• Main Authors: Yu-Lin Chen, 陳玉凌
• Other Authors: Hsueh-Yi Lu
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/03223040157845863872

碩士 === 國立雲林科技大學 === 健康產業管理研究所碩士班 === 101 === Patients requiring long-term use of a ventilator increased in Taiwan because the population aging is growing. There are 11,573 catastrophic illness patients who chronic respiratory failure needed for ventilator support in Taiwan. The expenditure of patients using ventilator due to respiratory failure is only less than cancer and it accounted for 21.7 % of all cost of catastrophic illness hospitalization. The population of chronic respiratory failure is growing and everyone had 10% to 15% chance of getting ventilator dependent in their lifetime. The study was to investigate the respiratory failure rate after successful weaning from ventilator in chronic obstructive pulmonary disease patients (COPD) in different artificial airway and their cost effectness. This is a retrospective study. The data analyzed is taken from the National Health Insurance Research Database and corresponds to the years 2007-2010. The study population is COPD patients and SPSS software for further analysis. We found that there are 42.4% patients used endotracheal tubes and 57.6% patients used tracheostomy tube. There is no difference in weaning rate in these two groups. Patients who received tracheostomy prolonged mechanical ventilation and hospitalization and less medical expenditure. It revealed that patient had tracheostomy associated with better outcomes and lower healthcare consumption than endotracheal group. We also analyzed the top five causes of death in 2010. Patients in chronic obstructive pulmonary disease and ventilator dependent had more complication of pneumonia if they used endotracheal tube. Further analysis revealed that decreased weaning rates associated with the number of ventilator days. The study can predict weaning rate in COPD patients and their prognosis.