非侵入性正壓呼吸器對拔管失敗之影響

Background and Purpose: Mechanical ventilation can save the life of a patient with acute respiratory failure, but efforts should focus on weaning the patient from mechanical ventilation as rapidly as possible after recovery. Because complicationswith extubation failure are high and may increase morbidity and mortality, prevention of extubation failure is critically important. We applied BiPAP, a noninvasive mode of pressure support ventilation, in an attempt to decrease the rate of reintubation. Methods: We prospectively enrolled 100 patients who had undergone extubation by T-piece weaning for 2 h. After extubation, patients were randomly divided into 2 groups with an O2 mask ormask-BiPAP. Results: Extubation was successful in 85 patients (85%) and failed in 15 patients (15%). The extubation failure ratewas 18%in themask-BiPAP study group and 12% in the O2-mask control group, a difference that was not statistically significant. Among the 15 patients in whom extubation failed, 6 required reintubation and 2 died (2/15; 13.33%), but the reintubation rate (6/15; 40%) could have been reduced. Conclusion: Noninvasive ventilation did not affect the outcome of extubation after the 2-h T-piece trial.