The Effect of Mechanical Ventilation on Peripheral Perfusion Index and Its Association With the Prognosis of Critically Ill Patients

被引：33

作者：

Su, Longxiang ^{[1
,2
]}

Zhang, Ruiming ^{[3
]}

Zhang, Qing ^{[1
,2
]}

Xu, Qun ^{[4
,5
]}

Zhou, Xiang ^{[1
,2
]}

Cui, Na ^{[1
,2
]}

Wang, Hao

Wang, Xiaoting ^{[1
,2
]}

Chai, Wenzhao ^{[1
,2
]}

Rui, Xi ^{[1
,2
]}

Liu, Dawei ^{[1
,2
]}

Long, Yun ^{[1
,2
]}

机构：

[1] Peking Union Med Coll, Peking Union Med Coll Hosp, Dept Crit Care Med, Beijing, Peoples R China

[2] Chinese Acad Med Sci, Beijing, Peoples R China

[3] USTC Anhui Prov Hosp, Affiliated Hosp 1, Dept Discipline Evaluat & Qual Management, Hefei, Anhui, Peoples R China

[4] CAMS, Inst Basic Med Sci, Dept Epidemiol & Biostat, Beijing, Peoples R China

[5] Peking Union Med Coll, Sch Basic Med, Beijing, Peoples R China

来源：

CRITICAL CARE MEDICINE | 2019年 / 47卷 / 05期

关键词：

critically ill patients; intensive care unit mortality; interaction; mean airway pressure; perfusion index; MEAN AIRWAY PRESSURE; PRETERM INFANTS; CARDIAC-OUTPUT; VARIABILITY; PREDICTOR; SIGNAL;

D O I：

10.1097/CCM.0000000000003661

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objectives: This study aimed to explore the relationship between the variables of mechanical ventilation and circulatory perfusion and its association with ICU mortality during the first day of mechanical ventilation. Design: Retrospective cohort study. Setting: The Department of Critical Care Medicine, Peking Union Medical College Hospital. Patients: Patients who have undergone mechanical ventilation. Interventions: None. Measurements and Main Results: This study used the main clinical data obtained from the real-time bedside messaging systems of mechanically ventilated patients during their first day in the ICU from May 2013 to May 2016, including data on the variables of mechanical ventilation and circulatory perfusion. An analysis was then performed on the association of the above data with the patient's in-ICU mortality. There were 5,103 patients who received mechanical ventilation during this period, and of these, 309 patients died during their ICU treatment. Peak airway pressure, mean airway pressure, respiratory rate, heart rate, mean arterial pressure, Fio(2), blood oxygen saturation, Po-2, peripheral perfusion index, and lactate level were correlated with patient outcomes. A Cox logistic regression analysis suggested that mean airway pressure and perfusion index were the most independent risk and protective factors, respectively, for patient ICU mortality. The areas under the curve for a poor prognosis for mean airway pressure and perfusion index were 0.799 (95% CI, 0.77-0.829) and 0.759 (95% CI, 0.729-0.789), respectively. Further, mean airway pressure and perfusion index exhibited a causal interaction. The relative excess risk due to interaction was 2.061 (-0.691 to 4.814), the attributable proportion due to interaction was 0.210 (-0.027 to 0.447), and the synergy index was 1.306 (0.930-1.833). Conclusions: A higher mean airway pressure and lower perfusion index provided a worse prognosis in mechanically ventilated patients, and it appears that these two variables have a casual interaction.

引用

页码：685 / 690

页数：6

共 19 条

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