Hemoglobin levels and weaning outcome of mechanical ventilation in difficult-to-wean patients: a retrospective cohort study
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. This retrospective co...
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| Veröffentlicht in: | PloS one 2013-08, Vol.8 (8), p.e73743-e73743 |
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| creator | Lai, Yi-Chun Ruan, Sheng-Yuan Huang, Chun-Ta Kuo, Ping-Hung Yu, Chong-Jen |
| description | 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.
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.
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 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).
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. |
| doi_str_mv | 10.1371/journal.pone.0073743 |
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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.
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).
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0073743</identifier><identifier>PMID: 24015310</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Aged ; Aged, 80 and over ; Anemia ; Biochemistry ; Blood ; Blood transfusions ; Chronic obstructive pulmonary disease ; Cohort analysis ; Criteria ; Critical care ; Female ; Follow-Up Studies ; Hemoglobin ; Hemoglobins - metabolism ; Hospitals ; Humans ; Internal medicine ; Male ; Mechanical ventilation ; Medical records ; Medicine ; Middle Aged ; Multivariate analysis ; Patients ; Physiology ; Pulmonary Disease, Chronic Obstructive - blood ; Pulmonary Disease, Chronic Obstructive - therapy ; Regression analysis ; Regression models ; Retrospective Studies ; Sepsis ; Studies ; Teaching methods ; Time Factors ; Transfusion ; Ventilation ; Ventilator Weaning ; Ventilators ; Weaning</subject><ispartof>PloS one, 2013-08, Vol.8 (8), p.e73743-e73743</ispartof><rights>2013 Lai et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2013 Lai et al 2013 Lai et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-d8a07d3a2436a3ad72d65cb39ff0c2fc5a906205aa479bdec894bd34939daea3</citedby><cites>FETCH-LOGICAL-c526t-d8a07d3a2436a3ad72d65cb39ff0c2fc5a906205aa479bdec894bd34939daea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3756003/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3756003/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24015310$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Rosenberger, Peter</contributor><creatorcontrib>Lai, Yi-Chun</creatorcontrib><creatorcontrib>Ruan, Sheng-Yuan</creatorcontrib><creatorcontrib>Huang, Chun-Ta</creatorcontrib><creatorcontrib>Kuo, Ping-Hung</creatorcontrib><creatorcontrib>Yu, Chong-Jen</creatorcontrib><title>Hemoglobin levels and weaning outcome of mechanical ventilation in difficult-to-wean patients: a retrospective cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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.
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).
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.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anemia</subject><subject>Biochemistry</subject><subject>Blood</subject><subject>Blood transfusions</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Cohort analysis</subject><subject>Criteria</subject><subject>Critical care</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hemoglobin</subject><subject>Hemoglobins - metabolism</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Internal medicine</subject><subject>Male</subject><subject>Mechanical ventilation</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Patients</subject><subject>Physiology</subject><subject>Pulmonary Disease, Chronic Obstructive - blood</subject><subject>Pulmonary Disease, Chronic Obstructive - therapy</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Retrospective Studies</subject><subject>Sepsis</subject><subject>Studies</subject><subject>Teaching methods</subject><subject>Time Factors</subject><subject>Transfusion</subject><subject>Ventilation</subject><subject>Ventilator Weaning</subject><subject>Ventilators</subject><subject>Weaning</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNptUk1v1DAQjRCIlsI_QGCJC5cs_sgnByRUAa1UiUvv1sSe7HrlxMF2tqr483W6adUiTrZm3nt-M35Z9p7RDRM1-7J3sx_BbiY34obSWtSFeJGdslbwvOJUvHxyP8nehLCntBRNVb3OTnhBWSkYPc3-XuDgttZ1ZiQWD2gDgVGTG4TRjFvi5qjcgMT1ZEC1S0UFlhxwjMZCNG4kiadN3xs125hHly9MMqVewoSvBIjH6F2YUEVzQKLczvlIQpz17dvsVQ824Lv1PMuuf_64Pr_Ir37_ujz_fpWrklcx1w3QWgvghahAgK65rkrVibbvqeK9KqGlacgSoKjbTqNq2qLTomhFqwFBnGUfj7KTdUGuawuSFbwpS0p5mxCXR4R2sJeTNwP4W-nAyPuC81sJPhplUXadQGQ9K6CtC9U3DecVTW44U0Iriknr2_ra3A2oVVqDB_tM9HlnNDu5dQcp6rKiVCSBz6uAd39mDFEOJii0FkZ08-JbMN6WFVt8f_oH-v_piiNKpX8IHvtHM4zKJUoPLLlESa5RSrQPTwd5JD1kR9wBBPLK-A</recordid><startdate>20130828</startdate><enddate>20130828</enddate><creator>Lai, Yi-Chun</creator><creator>Ruan, Sheng-Yuan</creator><creator>Huang, Chun-Ta</creator><creator>Kuo, Ping-Hung</creator><creator>Yu, Chong-Jen</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20130828</creationdate><title>Hemoglobin levels and weaning outcome of mechanical ventilation in difficult-to-wean patients: a retrospective cohort study</title><author>Lai, Yi-Chun ; Ruan, Sheng-Yuan ; Huang, Chun-Ta ; Kuo, Ping-Hung ; Yu, Chong-Jen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-d8a07d3a2436a3ad72d65cb39ff0c2fc5a906205aa479bdec894bd34939daea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anemia</topic><topic>Biochemistry</topic><topic>Blood</topic><topic>Blood transfusions</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Cohort analysis</topic><topic>Criteria</topic><topic>Critical care</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hemoglobin</topic><topic>Hemoglobins - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lai, Yi-Chun</au><au>Ruan, Sheng-Yuan</au><au>Huang, Chun-Ta</au><au>Kuo, Ping-Hung</au><au>Yu, Chong-Jen</au><au>Rosenberger, Peter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hemoglobin levels and weaning outcome of mechanical ventilation in difficult-to-wean patients: a retrospective cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2013-08-28</date><risdate>2013</risdate><volume>8</volume><issue>8</issue><spage>e73743</spage><epage>e73743</epage><pages>e73743-e73743</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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.
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).
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24015310</pmid><doi>10.1371/journal.pone.0073743</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Anemia Biochemistry Blood Blood transfusions Chronic obstructive pulmonary disease Cohort analysis Criteria Critical care Female Follow-Up Studies Hemoglobin Hemoglobins - metabolism Hospitals Humans Internal medicine Male Mechanical ventilation Medical records Medicine Middle Aged Multivariate analysis Patients Physiology Pulmonary Disease, Chronic Obstructive - blood Pulmonary Disease, Chronic Obstructive - therapy Regression analysis Regression models Retrospective Studies Sepsis Studies Teaching methods Time Factors Transfusion Ventilation Ventilator Weaning Ventilators Weaning |
| title | Hemoglobin levels and weaning outcome of mechanical ventilation in difficult-to-wean patients: a retrospective cohort study |
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