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Noizet, O.; Leclerc, F.; Ardıç, Sadık; Grandbastien, Bruno; Riou, Yvon; Dorkenoo, Aimée; Fourier, C.; Cremer, R.; Leteurtre, Stéphane

doi:10.1186/cc3898

Cited by 19 publications

(31 citation statements)

References 60 publications

(92 reference statements)

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“…Beside this, measuring respiratory muscles strength helps to determine the benefits of respiratory muscle training[ 6 – 8 ]. PImax can also be studied as a predictive evaluation for successfully weaning children from mechanical ventilation systems [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Reference Equation for Respiratory Pressures in Pediatric Population: A Multicenter Study

et al. 2015

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Previous studies have proposed only one prediction equation for respiratory muscle strength without taking into consideration differences between ages in pediatric population. In addition, those researches were single-center studies. The objective of this study was to establish reference equations for maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax) in children and teenagers. In a multicenter study, 450 healthy volunteers were evaluated (aged 6–18yrs). There were included volunteers with normal lung function. We excluded volunteers who could not perform the tests; participated in physical activity more than twice a week; were born prematurely; smokers; chronic respiratory, cardiologic, and/or neurologic diseases; had acute respiratory disease during the prior three weeks. The volunteers were divided into two groups: Group 6–11 (6–11yrs) and Group 12–18 (12–18yrs). PImax and PEmax were measured according to statement. The mean PImax value was 85.6 (95%IC 83.6–87.6 cmH2O), and PEmax 84.6 (95%IC 85.5–86.2 cmH2O). The prediction equations for PImax and PEmax for Group 6–11 were 37.458–0.559 + (age * 3.253) + (BMI * 0.843) + (age * gender * 0.985); and 38.556 + 15.892 + (age * 3.023) + (BMI * 0.579) + (age * gender * 0.881), respectively (R2 = 0.34 and 0.31, P<0.001). The equations for Group 12–18 were 92.472 + (gender * 9.894) + 7.103, (R2 = 0.27, P = 0.006) for PImax; and 68.113 + (gender * 17.022) + 6.46 + (BMI * 0.927), (R2 = 0.34, P<0.0001) for PEmax. This multicenter study determined the respiratory muscle strength prediction equations for children and teenagers.

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Section: Introductionmentioning

confidence: 99%

Reference Equation for Respiratory Pressures in Pediatric Population: A Multicenter Study

et al. 2015

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“…CVC assesses pulmonary function, while PIFR assesses airway resistance and MIP is an indicator of muscular strength and /or the state of the chest wall and lung. Previous studies in pediatric patients have shown that the CVC value predicting successful extubation was 15 ml/kg in neonates and infants less than 1 year old, while the predictive value of MIP was 45–60 cmH 2 O [ 10 – 13 ]. These values are similar to the results obtained in our study, which were MIP ≥ 17 ml/kg and MIP ≥ 50 cmH 2 O.…”

Section: Discussionmentioning

confidence: 99%

Detection and validation of predictors of successful extubation in critically ill children

Toida¹,

Muguruma²,

Miyamoto³

2017

PLoS ONE

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IntroductionAvailability of objective criteria for predicting successful extubation could avoid unnecessary prolongation of mechanical ventilation and/or inadvertent premature extubation, but the predictors of successful extubation in children are unclear. This study was performed to detect and validate respiratory function predictors of successful extubation in children admitted to the pediatric critical care unit.MethodsA retrospective chart review from 2010 to 2012 identified 463 patients, who were divided into a derivation cohort (n = 294) and a validation cohort (n = 169).ResultsThe incidence rate of failed extubation was 5% and 9% in the derivation and validation cohorts, respectively. The optimal cut-off values of crying vital capacity (CVC), peak inspiratory flow rate (PIFR), and maximum inspiratory pressure (MIP) were 17 ml/kg, 3.5 ml/sec/cm, and 50 cmH2O, respectively. The pass rates of CVC, PIFR, and MIP were 54.2%, 92.7%, and 55.5%, respectively. In the validation cohort, the successful extubation rate was 97.9% for patients who passed all 3 respiratory tests, 88.8% for those who passed at least one test, and 66.7% for those who failed all of the tests. Extubation failed in 5 patients who passed all three respiratory tests and failure was due to postoperative respiratory muscle fatigue or upper airway impairment.ConclusionsWe detected and validated predictors of successful extubation in critically ill children. A combination of CVC, PIFR, and MIP may be used to predict successful extubation for critically ill children. It is necessary to pay attention when extubating patients with postoperative respiratory muscle fatigue or upper airway impairment due to disturbance of consciousness and/or glottal edema even if they pass the respiratory function tests.

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“…Maximal inspiratory pressure during an occlusion test (Pi max ), modified tension timed index (TTI) (Matthew. 2008 ; Noizet et al 2005 ; Jabour et al 1991 ) and dead space to tidal volume ratio (VD/VT) (Harikumar et al 2009 ) would have strengthened the study. As the measurement of these variables requires expertise and special instruments we were unable to perform the same.…”

Section: Limitation Of the Studymentioning

confidence: 99%

“…Indices developed to predict weaning and extubation success (ES) are no better than clinical judgment (Newth et al 2009 ). Similarly, Leclerc and Schindler observed that adult weaning predictors proposed by the Task Force of the American College of Chest Physicians have very poor predictive power in children (Yang and Tobin 1991 ; Leclerc et al 2005 ; Schindler. 2005 ).…”

Section: Introductionmentioning

confidence: 94%

Prediction of extubation failure in newborns, infants and children: brief report of a prospective (blinded) cohort study at a tertiary care paediatric centre in India

2015

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BackgroundExtubation failure (EF), defined as need for re-intubation within 24–72 h, is multifactorial. Factors predicting EF in adults generally are not useful in children.ObjectiveTo determine the factors associated with EF and to facilitate prediction of EF in mechanically ventilated infants and children less than 12 years of age.Material and MethodsDesign Prospective cohort study. Setting PICU and NICU of a multispecialty tertiary care institute. Patients All consecutive newborns, infants and children, who remained on the ventilator for more than 12 h, were included. Patients with upper airway obstruction, neuromuscular disorders, complex anatomic malformations, accidental extubation, tracheostomy or death before extubation were excluded. Methods The pre-extubation clinical, laboratory and ventilatory parameters were collected for 92 cases over a one and half year period. The EF rate was calculated for each variable using STATA 9. All the treating physicians were blinded to the data collection procedure.Measurements and ResultsDemographics were comparable between the extubation success and EF groups. Respiratory failure was the main cause requiring ventilation (46.74 %, 95 % CI 0.37–0.57) as well as EF (30.23 %, 95 % CI 0.08–0.23). 76.92 % (95 % CI 0.58–0.89) of patients that failed extubation had alterations in respiratory effort, 38.46 % (95 % CI 0.22–0.57) each had either poor or increased respiratory effort. Poor cough reflex (p = 0.001), thick endotracheal secretions (p = 0.02), failed spontaneous breathing trial (SBT) (p = 0.001) and higher rapid shallow breathing index (RSBI) (p = 0.001) were found to be associated with EF.ConclusionsPaediatric EF is multifactorial. Increased or poor respiratory effort and failed SBT are potential factors in deciding re-intubation. Increased RSBI, poor cough reflex and thick.

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Abstract: Introduction We conducted the present study to determine whether a combination of the mechanical ventilation weaning predictors proposed by the collective Task Force of the American College of Chest Physicians (TF) and weaning endurance indices enhance prediction of weaning success.

Cited by 19 publications

References 60 publications

Reference Equation for Respiratory Pressures in Pediatric Population: A Multicenter Study

Reference Equation for Respiratory Pressures in Pediatric Population: A Multicenter Study

Detection and validation of predictors of successful extubation in critically ill children

Prediction of extubation failure in newborns, infants and children: brief report of a prospective (blinded) cohort study at a tertiary care paediatric centre in India

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