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Revista de la Facultad de Medicina
versão impressa ISSN 0120-0011
Resumo
RIASEOS, Lorena Enriquez e GARCIA-PERDOMO, Herney Andrés. Risk factors associated with failed weaning from mechanical ventilation in septic patients admitted to an intensive care unit: a case-control study. rev.fac.med. [online]. 2022, vol.70, n.4, e202. Epub 08-Mar-2023. ISSN 0120-0011. https://doi.org/10.15446/revfacmed.v70n4.94464.
Introduction:
Several risk factors associated with weaning failure may be observed in septic patients requiring invasive mechanical ventilation.
Objective:
To determine the risk factors associated with weaning failure in septic patients admitted to an intensive care unit (ICU) in Cali, Colombia, between January 2014 and June 2018.
Materials and methods:
Case-control study conducted in 315 patients who required mechanical ventilation for more than 48 hours and were distributed as follows: 105 cases (weaning failure) and 210 controls (successful weaning). Information about sociodemographic and clinical variables was obtained from their medical records. A bivariate analysis was performed to determine the association between each independent variable and weaning failure. A multivariate analysis was also carried out using a logistic regression model in which the variables with a p<0.20 in the bivariate analysis were entered. A significance level of p≤0.05 was considered.
Results:
Requiring mechanical ventilation for more than 7 days (OR: 15.13; 95%CI: 8.25-27.74), having a high APACHE II score (mortality risk >50%) on ICU admission (OR: 3.16; 95%CI: 1.73-5.77), and having diuresis ≤0.5 mL/kg/h (OR: 1.87; 95%CI: 1.0-3.50) were significantly associated with weaning failure.
Conclusions:
Requiring mechanical ventilation for more than 7 days, having diuresis ≤0.5ml/kg/h, as well as a high APACHE ll score on ICU admission were risk factors associated with failed weaning from mechanical ventilation in this study; however, age, blood urea nitrogen, creatinine, and positive fluid balance were not significantly associated with it, despite being described as risk factors in the literature.
Palavras-chave : Sepsis; Respiration, Artificial; Ventilator Weaning (MeSH).