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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.

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Related in: MedlinePlus

Probability of weaning success in patients with different hemoglobin levels (P = 0.06 by the log-rank test).
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pone-0073743-g002: Probability of weaning success in patients with different hemoglobin levels (P = 0.06 by the log-rank test).

Mentions: Table 2 shows the odds ratios for weaning success with regards to hemoglobin levels, age, sex and comorbidity. In univariate analysis, hemoglobin levels of 8-10 g/dL and > 10 g/dL were positively associated with weaning success compared to a hemoglobin level of < 8 g/dL (OR, 3.69; 95% CI, 1.22 to 11.15 and OR, 4.16, 95% CI, 1.30 to 13.29, respectively). In addition, there was a significant dose–response relationship in hemoglobin levels (P for trend= 0.03). Figure 2 demonstrates the curves of probability of weaning success for patients with different hemoglobin levels.


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)

Probability of weaning success in patients with different hemoglobin levels (P = 0.06 by the log-rank test).
© Copyright Policy
Related In: Results  -  Collection

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

pone-0073743-g002: Probability of weaning success in patients with different hemoglobin levels (P = 0.06 by the log-rank test).
Mentions: Table 2 shows the odds ratios for weaning success with regards to hemoglobin levels, age, sex and comorbidity. In univariate analysis, hemoglobin levels of 8-10 g/dL and > 10 g/dL were positively associated with weaning success compared to a hemoglobin level of < 8 g/dL (OR, 3.69; 95% CI, 1.22 to 11.15 and OR, 4.16, 95% CI, 1.30 to 13.29, respectively). In addition, there was a significant dose–response relationship in hemoglobin levels (P for trend= 0.03). Figure 2 demonstrates the curves of probability of weaning success for patients with different hemoglobin levels.

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