Influencing Factors Of Difficult Weaning From Mechanical Ventilation After Surgeries In Elderly Patients

Objective:To explore influencing factors in elderly postoperative patients who were difficult to be weaned from mechanical ventilation.Methods:92 patients were enrolled into this retrospective study and were divided into two groups:extubation success group and extubation failure group based on whether they extubated in 48 hours or not.Clinical data were collected and analyzed.Results:24 patients failed to be weaned from mechanical ventilation in 48 hours(26.1%).The APACHE-?,inspiration pressure supported by the machine(P),partial pressure of oxygen(PaO2),fraction of inspiration O2(FiO2)were higher than the success group,and the PaO2/FiO2 was lower(p<0.05).Significant difference was observed in patients with emergency surgeries,patients with craniocerebral operations,infection of multidrug resistant bacteria between two groups(p<0.05).Patients with emergency surgeries,infection of multidrug resistant bacteria,patients with craniocerebral operations,high APACHE-?,high inspiration pressure before weaning were independent risk factors of extubation process.The area under cure(AUC)of the ROC cure of inspiration pressure before weaning and APACHE-?to predict the weaning failure were 0.850 and 0.826,when the cut-off level were 11 cmH20 and 18.5 points.The sensitivity of inspiration pressure before weaning was 100%,the specificity was 58.8%,and the APACHE-? score was 95.8%and 55.9%.Conclusion:Independent risk factors of difficult-to-wean after surgeries in elderly patients were patients with emergency surgeries,infection of multidrug resistant bacteria,patients with craniocerebral operations,high APACHE-?,high inspiration pressure.Inspiration pressure before weaning and APACHE-? score could predict weaning failure.