Limits...
Hemoglobin levels and weaning outcome of mechanical ventilation in difficult-to-wean patients: a retrospective cohort study.

Lai YC, Ruan SY, Huang CT, Kuo PH, Yu CJ - PLoS ONE (2013)

Bottom Line: Medical records were reviewed to obtain data on hemograms, biochemistry tests, transfusion records, comorbidities and weaning outcome.A total of 751 patients received mechanical ventilation during the study period, 138 of whom fulfilled the criteria of difficult weaning.Further studies are needed to evaluate whether a restrictive transfusion trigger for acute critical illness is also appropriate for such patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan ; Department of Medicine, National Yang-Ming University Hospital and School of Medicine, Taipei, Taiwan.

ABSTRACT

Introduction: The effect of hemoglobin levels on the weaning outcomes of mechanically ventilated patients remains under debate, particularly for the patients with difficult weaning. This study aims to evaluate the effect of hemoglobin levels on weaning outcomes in difficult-to-wean patients.

Methods: This retrospective cohort study was conducted in a university-affiliated teaching hospital in Taiwan. Patients who fulfilled the criteria of difficult weaning were enrolled. Medical records were reviewed to obtain data on hemograms, biochemistry tests, transfusion records, comorbidities and weaning outcome. The association between hemoglobin levels and 30-day weaning outcomes was evaluated using a logistic regression model.

Results: A total of 751 patients received mechanical ventilation during the study period, 138 of whom fulfilled the criteria of difficult weaning. Compared with the patients whose hemoglobin was <8 g/dL, those with higher hemoglobin levels were more likely to be successfully weaned (odds ratio [OR], 3.69; 95% CI, 1.22-11.15 for hemoglobin 8-10 g/dL and OR, 4.16, 95% CI, 1.30-13.29 for hemoglobin >10 g/dL). Multivariate analysis showed that the odds ratio for weaning success remained significant for hemoglobin levels of 8-10 g/dL (adjusted OR, 3.3; 95% CI, 1.07-10.15) with borderline significance for hemoglobin level > 10 g/dL (adjusted OR, 2.95, 95% CI, 0.88-9.96).

Conclusions: Hemoglobin level is independently associated with weaning outcome in difficult-to-wean patients. Further studies are needed to evaluate whether a restrictive transfusion trigger for acute critical illness is also appropriate for such patients.

Show MeSH

Related in: MedlinePlus

Study flow.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3756003&req=5

pone-0073743-g001: Study flow.

Mentions: A total of 751 patients receiving invasive mechanical ventilation for more than 24 hours were screened for eligibility. Among them, 138 patients who fulfilled the criteria of difficult or prolonged weaning were included for analysis. Figure 1 shows the study flow, and the characteristics of the study cohort are summarized in Table 1. The mean hemoglobin level at the initiation of mechanical ventilation was 10.7 g/dL and the average interval in blood testing for complete blood count was 2.5 ± 1.8 days.


Hemoglobin levels and weaning outcome of mechanical ventilation in difficult-to-wean patients: a retrospective cohort study.

Lai YC, Ruan SY, Huang CT, Kuo PH, Yu CJ - PLoS ONE (2013)

Study flow.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3756003&req=5

pone-0073743-g001: Study flow.
Mentions: A total of 751 patients receiving invasive mechanical ventilation for more than 24 hours were screened for eligibility. Among them, 138 patients who fulfilled the criteria of difficult or prolonged weaning were included for analysis. Figure 1 shows the study flow, and the characteristics of the study cohort are summarized in Table 1. The mean hemoglobin level at the initiation of mechanical ventilation was 10.7 g/dL and the average interval in blood testing for complete blood count was 2.5 ± 1.8 days.

Bottom Line: Medical records were reviewed to obtain data on hemograms, biochemistry tests, transfusion records, comorbidities and weaning outcome.A total of 751 patients received mechanical ventilation during the study period, 138 of whom fulfilled the criteria of difficult weaning.Further studies are needed to evaluate whether a restrictive transfusion trigger for acute critical illness is also appropriate for such patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan ; Department of Medicine, National Yang-Ming University Hospital and School of Medicine, Taipei, Taiwan.

ABSTRACT

Introduction: The effect of hemoglobin levels on the weaning outcomes of mechanically ventilated patients remains under debate, particularly for the patients with difficult weaning. This study aims to evaluate the effect of hemoglobin levels on weaning outcomes in difficult-to-wean patients.

Methods: This retrospective cohort study was conducted in a university-affiliated teaching hospital in Taiwan. Patients who fulfilled the criteria of difficult weaning were enrolled. Medical records were reviewed to obtain data on hemograms, biochemistry tests, transfusion records, comorbidities and weaning outcome. The association between hemoglobin levels and 30-day weaning outcomes was evaluated using a logistic regression model.

Results: A total of 751 patients received mechanical ventilation during the study period, 138 of whom fulfilled the criteria of difficult weaning. Compared with the patients whose hemoglobin was <8 g/dL, those with higher hemoglobin levels were more likely to be successfully weaned (odds ratio [OR], 3.69; 95% CI, 1.22-11.15 for hemoglobin 8-10 g/dL and OR, 4.16, 95% CI, 1.30-13.29 for hemoglobin >10 g/dL). Multivariate analysis showed that the odds ratio for weaning success remained significant for hemoglobin levels of 8-10 g/dL (adjusted OR, 3.3; 95% CI, 1.07-10.15) with borderline significance for hemoglobin level > 10 g/dL (adjusted OR, 2.95, 95% CI, 0.88-9.96).

Conclusions: Hemoglobin level is independently associated with weaning outcome in difficult-to-wean patients. Further studies are needed to evaluate whether a restrictive transfusion trigger for acute critical illness is also appropriate for such patients.

Show MeSH
Related in: MedlinePlus