The Application Of The Work Of Breathing And Ti/Ttot On Weaning Of Ventilator

ObjectiveDuring study of the patient needed weaning of ventilator,to explore the application of the Work of Breathing and Ti/Ttot on weaning of ventilator.MenthodUse prospective study on 86 patienta who were accorder with general weaning parameter and ventilator time above 72 hours in EICU.Then baseing on clinical diagnoses,they were divided into 2 group(COPD group and acute toxicosis group),furthermore basing on result for weaning to divided into 2 group(success group and failure group).To analysis the relative data with statistics method for clinical value on weaning.ResultsThe WOB in the success weaning group was(0.64±0.05) J/L,Ti/Ttot was (0.31±0.03).And the failure weaning group was(0.84±0.10) J/L,Ti/Ttot was (0.37±0.03).It was nearly to reference level(WOB＜0.75 J/L)nowadays.There were significant difference on heart rate,ventilation time,WOB and Ti/Ttot between success group and failure group.(P＜0.05).The results of Logistic demonstrated that the WOB and Ti/Ttot was relate to predict weaning of ventilation(both OR＞1).The result was that success 13 and failure 33 in COPD group.Meanwhile success 31 and failure 9 in acute toxicosis group.Furthermore the time of ventilation,WOB and Ti/Ttot of the acute toxicosis group obviously less than them of the COPD group.Conclusions The parameter of WOB and Ti/Ttot might have a useful effect on weaning of ventilator,but it cannot evaluate completely on weaning by itself,and it was used for weaning of ventilation as a supplement parameter.It was also needed with other parameters on clinical.Meanwhile the experience of the duty doctor also make important effect on weaning,because it would provide the essential support,so that respiration physiology of the patient reached the state of enduring weaning.Now the direction of weaning of ventilation is that synthesis analysis with multiple parameter combined,and it attempts to use noninvasive ventilation instead of invasive ventilation in some ways.It will appear more and more valuable parameter on weaning of ventilation for the patient with ventilation assisted.