MỐI LIÊN QUAN GIỮA HẠ PHOSPHO MÁU VÀ CAI THỞ MÁY THẤT BẠI Ở NGƯỜI BỆNH THỞ MÁY

Sơn Nguyễn Hồng; Phát Hồ Ngọc; Thành Bùi Đức; Vinh Lại Huy; Tính Lưu Viết; Khoa Nguyễn Việt Đăng; Xứng Nguyễn Văn; Quý Nguyễn Văn; Thúy Nguyễn Lưu Phương

doi:10.59354/ydth175.2023.103

Keywords:

phosphatemia, phosphorus, hypophosphatemia, weaning ventilator, weaning ventilation failure, , risk factors of weaning ventilation failure

Abstract

Background: The hypophosphatemia have been reported associated with weaning. However, the level of evidence is not strong enough. This study was performed which objective of study was to determine the association between the hypophosphatemia with weaning failure in invasive mechanical ventilation patients.

Methods: A prospective cohort with 94 weaning trials, which had enough the standards of weaning. There were included and exclusion criteria. The primary outcome was the weaning failure (yes/no). The control confounding variables were age group ≥ 65, malnutrition, COPD, heart failure, brain damage, and lung injury.

Results: The hypophosphatemia ≤ 0.8 mmol /l were 36 weaning trials (38.3%). The weaning failure was 32 weaning trials (34%). The weaning failure of the hypophosphatemia patients was (20 weaning trials, 55.6%), higher than the normal phosphatemia patients (12 weaning trials, 20.7%). Stratified analysis, the control variable is not interactive elements, and confounders. Compared with normal phosphatemia, the hypophosphatemia increases the risk of weaning failure with RR = 2.69, 95% confidence interval from 1.5 to 4.81, p <0.01.

Conclusion: through this study, the results showed hypophosphatemia increased 3 times the risk of weaning failure, prolonged duration of mechanical ventilation. Therefore, the blood phosphorus should be interested in tracking and adjusted in blood phosphorus decreased, blood phosphorus decreased especially in mechanically ventilated patients.

References

Huỳnh Văn Bình (2015). Sự liên quan giữa giảm phospho máu với cai máy thất bại ở bệnh nhân thở máy. Tạp chí Y học, Đại học Y Dược TP HCM. 21(3):89- 96.

Huỳnh Văn Ân (2013). Hạ phosphat máu ở bệnh nhân thông khí cơ học. Tạp chí Y học, Đại học Y Dược TP HCM. 17(6):106-109.

Rady HI, Khalek M (2014). Prevalence and risk factors of hypophosphatemia in pediatric intensive care unit. J Anesth Crit Care Open Access. 1(6):25-26.

Mohammad H. Alsumrain, et al (2010). Association of hypophosphatemia with failure-to-wean from mechanical ventilation. Ann Clin Lab Sci. 40(2):144- 148.

Zhao Y, Li Z, Shi Y, et al (2016). Effect of hypophosphatemia on the withdrawal of mechanical ventilation in patients with acute exacerbations of chronic obstructive pulmonary disease. Biomed Rep. 4(4):413-416.

Talakoub R, et al (2017). The Predicting Ability of Serum Phosphorus to Assess the Duration of Mechanical Ventilation in Critically Ill Patients. Adv Biomed Res. 6(51):56-58.

M.M. Berger, et al (2020). Prevalence of hypophosphatemia in the ICU - Results of an international one-day point prevalence survey. Clinical Nutrition. 40(5):3615-3621.

Federspiel CK, Itenov TS, Thormar KM, Bestle M (2016). The Effect Of Low Phosphate Levels On Respiratory Failure And Mortality In Critically Ill Patients. American Thoracic Society. :A3648-A3648.

Agusti AG, et al (1984). Hypophosphatemia as a cause of failed weaning: the importance of metabolic factors. Crit Care Med. 12(2):142-143.

Boles JM, Bion J, Connors A, et al (2010). Weaning from mechanical ventilation. Eur Respir J. 29(5):1033- 1056.