Preditores de falha da extubação em crianças no pós-operatório de cirurgia cardíaca submetidas à ventilação pulmonar mecânica

Johnston, Cíntia; Piva, Jefferson Pedro; Carvalho, Werther Brunow de; García, Pedro Celiny Ramos; Fonseca, Marcelo Cunio Machado; Hommerding, Patrícia Xavier

doi:10.1590/s0103-507x2008000100009

Cited by 10 publications

(11 citation statements)

References 17 publications

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“…Similar to our study, a study was done in Portugal specifically for pediatric patients underwent cardiac surgery about evaluating multiple predictors used to predict extubation outcome. This similar study revealed no association between the RSBI measurements and extubation outcomes [20]. In other studies about pediatric patients in general, they found an association between the measurements of RSBI prior to extubation and the extubation outcomes which is a prediction of extubation success with low RSBI similar to the results in the two hours prior to extubation RSBI measurements in our study [9,10,22,23].…”

Section: Discussionsupporting

confidence: 81%

“…The ratio of extubation failure for pediatric patients underwent cardiac surgery at King Faisal Cardiac Center from 2016 to 2019 is 5.8%, which is in between the various ratios that have been reported in literature. However, in comparing the ratio in this study with other two studies that focused only on pediatric patients underwent cardiac surgeries, our extubation failure ratio is considered lower than both of the studies [20,21]. One of these studies about pediatric cardiac patients had an extubation failure ratio of 19% [20].…”

Section: Discussionmentioning

confidence: 81%

See 1 more Smart Citation

Rapid Shallow Breathing Index as a Predictor of Extubation Outcomes in Pediatric Patients Underwent Cardiac Surgeries at King Faisal Cardiac Center

Munshi

Bukhari

Alshaikh

et al. 2020

Cureus

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 81%

Rapid Shallow Breathing Index as a Predictor of Extubation Outcomes in Pediatric Patients Underwent Cardiac Surgeries at King Faisal Cardiac Center

Munshi

Bukhari

Alshaikh

et al. 2020

Cureus

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“…Based on the damage associated with the inappropriate duration of MV in newborn infants, there is a clear need to establish objective criteria for extubation, which would help to avoid undesirable outcomes, such as extubation failure ( 3 , 5 , 6 ) and reintubation, which bear direct associations with morbidity and mortality. ( 7 , 8 )…”

Section: Introductionmentioning

confidence: 99%

Predictors of extubation failure and reintubation in newborn infants subjected to mechanical ventilation

Costa¹,

Schettino²,

Ferreira³

2014

Revista Brasileira De Terapia Intensiva

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ObjectiveTo identify risk factors for extubation failure and reintubation in newborn infants subjected to mechanical ventilation and to establish whether ventilation parameters and blood gas analysis behave as predictors of those outcomes.MethodsProspective study conducted at a neonatal intensive care unit from May to November 2011. A total of 176 infants of both genders subjected to mechanical ventilation were assessed after extubation. Extubation failure was defined as the need to resume mechanical ventilation within less than 72 hours. Reintubation was defined as the need to reintubate the infants any time after the first 72 hours.ResultsBased on the univariate analysis, the variables gestational age <28 weeks, birth weight <1,000g and low Apgar scores were associated with extubation failure and reintubation. Based on the multivariate analysis, the variables length of mechanical ventilation (days), potential of hydrogen (pH) and partial pressure of oxygen (pO2) remained associated with extubation failure, and the five-minute Apgar score and age at extubation were associated with reintubation.ConclusionLow five-minute Apgar scores, age at extubation, length of mechanical ventilation, acid-base disorders and hyperoxia exhibited associations with the investigated outcomes of extubation failure and reintubation.

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“…In an investigation of 212 children after cardiothoracic surgery, Manrique et al (2007) found that, although a trend toward higher PCO 2 (48 versus 40 mmHg; p = 0.14) at the time of extubation was observed in the extubation failure group, there were no significant differences between the success and failure groups. Johnston et al (2008) evaluated 59 children undergoing cardiac surgery before and after extubation and also reported no significant difference between the failing and successful groups with Pa CO2 values of 37 ± 10 mmHg and 35 ± 10 mmHg, respectively (p = 0.54).…”

Section: Discussionmentioning

confidence: 95%

PET_CO₂measurement and feature extraction of capnogram signals for extubation outcomes from mechanical ventilation

2015

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Capnography is a continuous and noninvasive method for carbon dioxide (CO2) measurement, and it has become the standard of care for basic respiratory monitoring for intubated patients in the intensive care unit. In addition, it has been used to adjust ventilatory parameters during mechanical ventilation (MV). However, a substantial debate remains as to whether capnography is useful during the process of weaning and extubation from MV during the postoperative period. Thus, the main objective of this study was to present a new use for time-based capnography data by measuring the end-tidal CO2 pressure ([Formula: see text]), partial pressure of arterial CO2 ([Formula: see text]) and feature extraction of capnogram signals before extubation from MV to evaluate the capnography as a predictor of outcome extubation in infants after cardiac surgery. Altogether, 82 measurements were analysed, 71.9% patients were successfully extubated, and 28.1% met the criteria for extubation failure within 48 h. The ROC-AUC analysis for quantitative measure of the capnogram showed significant differences (p < 0.001) for: expiratory time (0.873), slope of phase III (0.866), slope ratio (0.923) and ascending angle (0.897). In addition, the analysis of [Formula: see text] (0.895) and [Formula: see text] (0.924) obtained 30 min before extubation showed significant differences between groups. The [Formula: see text] mean value for success and failure extubation group was 39.04 mmHg and 46.27 mmHg, respectively. It was also observed that high CO2 values in patients who had returned MV was 82.8 ± 21 mmHg at the time of extubation failure. Thus, [Formula: see text] measurements and analysis of features extracted from a capnogram can differentiate extubation outcomes in infant patients under MV, thereby reducing the physiologic instability caused by failure in this process.

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Preditores de falha da extubação em crianças no pós-operatório de cirurgia cardíaca submetidas à ventilação pulmonar mecânica

Cited by 10 publications

References 17 publications

Rapid Shallow Breathing Index as a Predictor of Extubation Outcomes in Pediatric Patients Underwent Cardiac Surgeries at King Faisal Cardiac Center

Rapid Shallow Breathing Index as a Predictor of Extubation Outcomes in Pediatric Patients Underwent Cardiac Surgeries at King Faisal Cardiac Center

Predictors of extubation failure and reintubation in newborn infants subjected to mechanical ventilation

PET_CO₂measurement and feature extraction of capnogram signals for extubation outcomes from mechanical ventilation

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Preditores de falha da extubação em crianças no pós-operatório de cirurgia cardíaca submetidas à ventilação pulmonar mecânica

Cited by 10 publications

References 17 publications

Rapid Shallow Breathing Index as a Predictor of Extubation Outcomes in Pediatric Patients Underwent Cardiac Surgeries at King Faisal Cardiac Center

Rapid Shallow Breathing Index as a Predictor of Extubation Outcomes in Pediatric Patients Underwent Cardiac Surgeries at King Faisal Cardiac Center

Predictors of extubation failure and reintubation in newborn infants subjected to mechanical ventilation

PETCO2measurement and feature extraction of capnogram signals for extubation outcomes from mechanical ventilation

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PET_CO₂measurement and feature extraction of capnogram signals for extubation outcomes from mechanical ventilation