Conventional Weaning Parameters Do Not Predict Extubation Outcome in Intubated Subjects Requiring Prolonged Mechanical Ventilation.
BACKGROUND: Approaches to respiratory care of patients needing prolonged mechanical ventilation (PMV) might be varied. In this study we assessed the predictive value of usual variables for extubation outcome in PMV patients. METHODS: From 2005 to 2007, intubated patients who were admitted to the int...
| Publicado en: | Respiratory Care Vol. 58; no. 8; pp. 1307 - 1315 |
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| Autores principales: | , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Aug2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104201159&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104201159 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Aug2013 vid: 58 iid: 8 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 104201159 89292496 10.4187/respcare.01773 NLM23307826 104201159 ppf: 1307 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Conventional Weaning Parameters Do Not Predict Extubation Outcome in Intubated Subjects Requiring Prolonged Mechanical Ventilation. aug: au: Chun-Ta Huang Chong-Jen Yu affil: Department of Internal Medicine and Traumatology, National Taiwan University Hospital, Taipei, Taiwan sug: subj: Ventilator Weaning Evaluation Respiration, Artificial Statistics and Numerical Data Human Predictive Value of Tests Retrospective Design APACHE (Acute Physiology and Chronic Health Evaluation) Clinical Assessment Tools Two-Tailed Test Fisher's Exact Test Chi Square Test Descriptive Statistics Data Analysis Software T-Tests Kaplan-Meier Estimator Cox Proportional Hazards Model Scales Male Female Middle Age Aged Middle Aged: 45-64 years Aged: 65+ years Male Female ab: BACKGROUND: Approaches to respiratory care of patients needing prolonged mechanical ventilation (PMV) might be varied. In this study we assessed the predictive value of usual variables for extubation outcome in PMV patients. METHODS: From 2005 to 2007, intubated patients who were admitted to the intermediate respiratory care unit, had been on mechanical ventilation for ≥ 21 days at the time of admission, and underwent extubation after successful spontaneous breathing trials were included. Comparisons between subjects with successful extubation and failed extubation in terms of weaning parameters and clinical predictors of extubation outcome were performed. Also, 1-year survival of subjects with regard to extubation outcome was analyzed. RESULTS: Twenty-seven (23.7%) of 119 PMV subjects required reintubation within 7 days. Multivariate logistic regression analysis demonstrated that the only variable associated with extubation failure was ineffective cough (P < .001). Possessing 2 or more acceptable weaning parameters was not helpful in predicting extubation outcome. Subjects with failed extubation had worse 1-year survival (hazard ratio 0.49, 95% CI 0.28-0.87, P = .02) compared with those with successful extubation. CONCLUSIONS: In PMV subjects who tolerated spontaneous breathing trials and were ready to extubate, ineffective cough was the best predictor of extubation failure. Furthermore, extubation failure was associated with future mortality; thus, different management strategies need to be developed for improving patient outcome. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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