Do simple ventilation and gas exchange measurements predict early successful weaning from respiratory support in unselected general intensive care patients?

British Journal of Anaesthesia
F MonacoT S Walsh

Abstract

The value of respiratory variables as weaning predictors in the intensive care unit (ICU) is controversial. We evaluated the ability of tidal volume (Vt(exp)), respiratory rate (f), minute volume (MV(exp)), rapid shallow breathing index (f/Vt), inspired-expired oxygen concentration difference [(I-E)O(2)], and end-tidal carbon dioxide concentration (Pe'(co(2))) at the end of a weaning trial to predict early weaning outcomes. Seventy-three patients who required >24 h of mechanical ventilation were studied. A controlled pressure support weaning trial was undertaken until 5 cm H(2)O continuous positive airway pressure or predefined criteria were reached. The ability of data from the last 5 min of the trial to predict whether a predefined endpoint indicating discontinuation of ventilator support within the next 24 h was evaluated. Pre-test probability for achieving the outcome was 44% in the cohort (n=32). Non-achievers were older, had higher APACHE II and organ failure scores before the trial, and higher baseline arterial H(+) concentrations. The Vt, MV, f, and f/Vt had no predictive power using a range of cut-off values or from receiver operating characteristic (ROC) analysis. The [I-E]O(2) and Pe'(co(2)) had weak discriminatory p...Continue Reading

References

Aug 1, 1995·American Journal of Respiratory and Critical Care Medicine·S K Epstein
Jul 1, 1996·The American Journal of Medicine·W ChatilaC A Manthous
Dec 16, 1998·American Journal of Respiratory and Critical Care Medicine·A JubranM J Tobin
Apr 26, 2000·The European Respiratory Journal·R AlvisiJ Milic-Emili
May 6, 2004·Intensive Care Medicine·Giorgio ContiMassimo Antonelli

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Citations

May 16, 2013·Journal of Cardiothoracic and Vascular Anesthesia·Fabrizio MonacoAlberto Zangrillo
Dec 18, 2014·Revista brasileira de enfermagem·Marcos Antônio Gomes BrandãoCândida Caniçali Primo
Sep 15, 2017·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Sahar EbrahimabadiHomeira Khoddam

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