中图分类号：R562；R563.8 文献标识码：A 文章编号：1009_816X(2011)04_0 267_03

    DOI:10.3969/j.issn.1009_816X.2011.04.06

    The Evaluation of Brain Natriuretic peptide during Weaning in ElderlyPatients with Chronic Obstructive Pulmonary Disease. XU Qiang_hong, YAN Jing, GONG Shi_jin, et al. Department of Intensiv e Care Unit, Zhejiang Hospital, Zhejiang 310012, China

    [Abstract] Objective To evaluate the utility of serial measure ments of plasmabrain natriuretic peptide (BNP) by detecting acute cardiac dysfunction during we aning failure for elderly patients with chronic obstructive pulmonary disease indifficult to wean.Methods 60 elderly patients with chronic obstructive pulmona ry disease were divided into two groups: BNP application group(30 cases)and st andard therapy group (30 cases). Cardiac and hemodynamic variables, arterial blo od gas, respiratory mechanics and indexes of oxygen cost of breathing, were meas ured and analyzed immediately before (baseline) and at the end of a spontaneousbreathing trial. Plasma levels of BNP and each measurement of BNP after every ho ur was measured in application BNP group. BNP was measured in Application BNP gr oup and according to BNP value, patients were divided into two groups: normal gr oup and increased group; Before and after weaning, LVEF was measured by echocard iographys.ResultsCompared with standard therapy group, HR SBP DBP SaO2 RR PaO2 /FiO2 PH, PaCO₂, PaO2 of the patients with increased BNP value in BNP appl ication group, increased significantly after SBT(P<0.05); Compared withnormal gr oup, HR SBP DBP SaO2 RR PaO2/FiO2 PH, PaCO₂, PaO2 of the patients withincreased BNP value in BNP application group increased significantly(P<0 .05). In BNP application group, patients who weaned successfully were more tha n the standard therapy group.Conclusions Serial measurements of BNP plasma levels provide a n oninvasive manner to detect acute cardiac dysfunction during an unsuccessful wea ning trial for the elderly patients in difficult to wean with chronic obstructiv e pulmonary disease in difficult to wean. The use of BNP can improve the successrate of weaning outcome. ......