| Summary: | 碩士 === 東海大學 === 工業工程與經營資訊學系 === 107 === BACKGROUND：The purpose of this study was to explore the predictive factors of successfully removed from the ventilator of delayed mechanical ventilation (respiratory device using ≧ for 21 days) of an adult patient who is in the respiratory care center (RCC) in a medical center of the central Taiwan.
METHODS：This was a retrospective observational study performed in an RCC. A total of 342 patients were transferred to RCC because of prolonged mechanical ventilation between January 2016 and December 2017. The demographics, clinical characteristics, and laboratory data were compared. Univariate analysis was performed to determine factors associated with prolonged mechanical ventilation, and logistic backward regression analysis identified the predictors associated with difficulties in weaning patients from mechanical ventilation.
RESULTS：According to mechanical ventilation weaning status, patients were divided into two groups of weaning successful and weaning failure. As a result, a total of 227 patients were successfully weaned from the mechanical ventilation, and the successful weaned rate was 66.4%. In the group of unsuccessful weaning, the following were significantly lower GCS scores (P =0.017), serum albumin(p=0.000), Hemoglobin(p=0.004), and lower serum prealbumin (p=0.002) compared to successfully weaned group. The following were all significantly higher in the unsuccessfully weaned group: APACHE II scores(p=0.000), length of RCC length of stay(p =0.000), and minute ventilation (p =0.046).Logistic backward regression analysis showed that the predictors of ventilator weaned failure were lower serum albumin (OR=0.4, p=0.006), higher APACHE II score (OR=1.1, p=0.009), and length of RCC length of stay (OR=1.2, p=0.000) and higher minute ventilation (OR=1.1, p=0.006).
CONCLUSION：High rates of ventilator independence can be achieved in an RCC setting as an alternative to ICU care. Predictors associated with ventilator weaning includes serum albumin, APACHE II score, RCC length of stay, and minute ventilation.
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