Predictive Value of End-Tidal Carbon Dioxide Partial Pressure,C-Reactive Protein/Albumin Ratio and Integrated Weaning Index on Weaning Failure in Patients with Severe Craniocerebral Injury Undergoing Mechanical Ventilation
Objective:To investigate the predictive value of end-tidal carbon dioxide partial pressure(PetCO2),C-reactive pro-tein/albumin ratio(CRP/Alb)and integrated weaning index(IWI)on weaning failure in patients with severe craniocerebral injury under-going mechanical ventilation.Methods:96 patients with severe craniocerebral injury who underwent mechanical ventilation in Lu'an Hospital Affiliated to Anhui University of Traditional Chinese Medicine from January 2020 to June 2022 were selected as research objects,according to the withdrawal results,they were divided into the weaning failure group(n=31)and the weaning success group(n=65).PetCO2,CRP/Alb,IWI and clinical parameters in the two groups before weaning were compared.Multivariate Logistic regression was used to analyze the risk factors of weaning failure in patients with severe craniocerebral injury undergoing mechanical ventilation.The predictive value of PetCO2,CRP/Alb and IWI for weaning failure in patients with severe craniocerebral injury undergoing mechani-cal ventilation was evaluated by receiver operating characteristic(ROC)curve.Results:PetCO2,CRP/Alb,acute physiology and chronic health evaluation scoring system Ⅱ(APACHE Ⅱ)score in the weaning failure group were significantly higher than those in the weaning success group,mechanical ventilation time was longer than that in the weaning success group,while IWI and glasgow coma score(GCS)were significantly lower than those in the weaning success group(P＜0.05).Multivariate Logistic regression analysis showed that PetCO2≥37.01 mmHg,CRP/Alb≥0.97,IWI≤78.23,GCS ≤5.90 scores,APACHE Ⅱ score≥26.17 scores,mechanical ventilation time≥4.49 d were the risk factors of weaning failure in patients with severe craniocerebral injury undergoing mechanical ventilation(P＜0.05).The ROC curve analysis showed that PetCO2,CRP/Alb,IWI,GCS,APACHE Ⅱ had high sensitivity and specificity for the weaning failure in patients with severe craniocerebral injury undergoing mechanical ventilation.The area under the curve(AUC)predicted by the combined detection of PetCO2,CRP/Alb,IWI for the weaning failure in patients with severe craniocerebral injury undergoing mechanical ventila-tion was higher than that of PetCO2,CRP/Alb,IWI,GCS,APACHE Ⅱ alone.Conclusion:The combined assessment of PetCO2,CRP/Alb and IWI has high predictive value for the weaning failure in patients with severe craniocerebral injury undergoing mechanical ventilation.
Severe craniocerebral injuryMechanical ventilationend-tidal carbon dioxide partial pressureC-reactive protein/albu-min ratioIntegrated weaning indexWeaning failurePredictive value
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