[Influential factors for mechanical ventilation offline in patients with severe pneumonia].

Objective: To determine the risk factors for mechanical ventilation offline in patients with severe pneumonia.
Methods: Th e data of 59 patients, who were admitted to the First Hospital of Changsha because of severe pneumonia and required mechanical ventilation between June 2011 and December 2013, were reviewed retrospectively. The patients were divided into two groups: a successful weaned group (n=31) and a failure group (n=28). Th e patients' background, laboratory and bacteriological examinations at the beginning of mechanical ventilation were recorded. All the indexes were analyzed by univariate analysis and logistic regression analysis.
Results: Univariate analysis showed that there was no significant difference in gender and age in the 2 groups (P>0.05). Smoker, APECHE II score, D-dimer and brain natriuretic peptide (BNP) concentration in the success weaned group were lower than those in the failure group. The difference between the 2 groups was significant (P<0.05). The serum albumin level in patients of the success weaned group at the time of entering respiratory intensive care unit was higher than that in the failure group, with significant difference (P<0.05). The logistic regression analysis showed that the high concentration of D-dimer, lung diseases based on thoracic CT and low serum albumin were independent risk factors for mechanical ventilation offline in severe pneumonia patients.
Conclusion: The severe pneumonia patients with low albumin, high concentration of D-dimer and lung diseases should be comprehensive evaluated and receive treatment, which is beneficial to the mechanical ventilation offline.