الفهرس 
Introduction and aim of the work
Mechanical ventilationOnly 14 pages are availabe for public view
 |  | from | 145 |  |  |
| | | from | 145 | | |
Abstract
The study was conducted on 100 patients who were admitted to Respiratory ICU at Assiut University Hospitals and required invasive mechanical ventilation due to different chest disease etiologies (e.g. chronic obstructive pulmonary disease, overlap syndrome, obesity hypoventilation syndrome and pneumonia) during the period from May 2016 to end of April 2018 and included: 50 patients needed reintubation with a mean age + SD of 66.06+10.3 years(29 males and 21 females) and 50 patients non-reintubated with a mean age + SD of 61.12±8.7 years(39 males and 11 females).
Patients undergone general examination, detailed chest examination, laboratory investigations and arterial blood sampling at the 1st intubation, during the follow up period on mechanical ventilation, during extubation in both groups and at the day of reintubation in reintubated group.
The observed data were collected and analyzed to detect factors associated with weaning failure .According to our results; these factors includes age, sex, smoking, Hb, hematocrit, PH, PO2, amount of secretion, type of weaning where is (simple, difficult or prolonged), NIV use after extubation, SAPS II Score and estimated mortality rate at the time of extubation, RSBI and lastly the duration of ICU and hospital stay.
Conclusion and recommendations:
1- Ventilator associated pneumonia is a life threatening complication of prolonged mechanical ventilation and every effort should be introduced to encourage early weaning and prevent it.
2- Arterial PH and PaO2 of first intubation can be used as a predictors of weaning failure and reintubation.
3- Excessive secretions could be used as a predictor of weaning failure so regular suctioning and good medical treatment is required to prevent it.
4- Daily assessment of patients for weaning readiness criteria is necessary to avoid prolonged and difficult weaning and subsequent weaning failure and reintubation.
5- Non-invasive ventilation should be encouraged in weaning failure patients to minimize the risk of reintubation and complications of mechanical ventilation.
6- SAPS II Score and Estimated Mortality Rate could be calculated at time of extubation to declare those patients with high risk of reintubation and special care should be rendered to those patients to avoid reintubation.
7- Early prevention and management of complications of intubation is necessary to reduce the duration of mechanical ventilation, hospital and ICU stay.
8- Elderly patients and those presented by pneumonia at time of admission has a higher risk of weaning failure and reintubation