Influencing factors of weaning failure in AECOPD patients with respiratory failure treated by invasive mechanical ventilation
Objective:To investigate the influencing factors of weaning failure in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with respiratory failure treated with invasive mechanical ventilation.Methods:The clinical data of 122 patients with AECOPD complicated with respiratory failure admitted to our hospital from January 2021 to December 2023 were retrospectively analyzed,and all the patients were treated with invasive mechanical ventilation.According to the weaning situation after treatment,the patients were divided into the successful weaning group and the failure weaning group,and the influencing factors of weaning failure were analyzed.Results:A total of 122 patients with AECOPD and respiratory failure treated with invasive mechanical ventilation were included,including 95 cases(77.87%)of successful weaning and 27 cases(22.13%)of failed weaning.Univariate analysis showed that there were significant differences in age,body mass index(BMI),diabetes,hemoglobin(Hb)before intubation,Hb at extubation,white blood cell count(WBC)at extubation,neutrophil fraction(NEU%)at extubation,C-reactive protein(CRP)at extubation,and albumin(ALB)at extubation between the two groups(all P<0.05);and the incidence of multiple organ dysfunction syndrome(MODS)and ventilator-associated pneumonia,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,and mechanical ventilation time in the successful weaning group were lower than those in the failure weaning group(all P<0.05).Multivariate logistic regression analysis showed that age,BMI,diabetes,Hb before intubation,Hb at extubation,NEU%at extubation,ALB level at extubation,MODS,APACHE Ⅱ score,and mechanical ventilation time were risk factors for weaning failure in patients with AECOPD and respiratory failure treated with invasive mechanical ventilation(all P<0.05).Conclusion:The influencing factors of weaning failure in AECOPD patients with respiratory failure treated by invasive mechanical ventilation are complex and diverse.Risk factors should be identified,and targeted treatment measures should be taken to reduce the incidence of weaning failure and improve the prognosis.
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