Logistic regression analysis between the weaning outcome of patients with septic shock and EVLWI and ITBI

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Objective To explore the values of extravascular lung water index (EVLW) and preload parameters in predicting the risk of weaning form mechanical ventilation in patients with septic shock.Methods A total of 93 septic-shock patients with mechanical ventilation were enrolled from January 2011 to March 2012 in Guangdong General Hospital.All patients were treated under PiCCO-monitoring till they reached weaning standards.After that,spontaneous breathing trial,weaning and extubation was performed in turn on patients.The patients were divided into two groups,including success group and failure groupaccording to clinical outcome after weaning within 48 hours.EVLWI preload parameters such as global enddiastolic volume index (GEDI),and intrathoracic blood volume index (ITBI) were examined at time points before and after weaning,including TO (before weaning),T1 (1/2 h after weaning),T2 (1/2 h after extubation),respectively.t-test,ANOVA were carried out to analyze the difference in parameters between two groups,and logistic regression analysis was conducted to investigate the risk of factors mentioned above in weaning failure under septic-shock settings.Results At the time of T1 and T2,both groups showed the increasing trend of LG (ITBI),LG (GEDI) and EVLWI.Compared with the success group,the failure group had significantly higher level of EVLWI,GEDI and ITBI during weaning (P ＜ 0.05).Logistic regression analysis revealed that EVLWI and ITBI were risk factors for weaning failure from mechanical ventilation of patients with septic shock.Conclusion EVLWI and ITBI were correlated closely to weaning outcome of patients with sepsis shock after form mechanical ventilation.The high level of EVLWI and ITBI increased the risk of weaning during evacuating from mechanical ventilation. Key words: Septic shock;  Mechanical ventilation;  Weaning from mechanical ventilation; Extravascular lung water index;  Volumetric parameter;  Logistics regression;  Global enddiastolic volume index;  Intrathoracic blood volume index

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