2015
DOI: 10.5935/1678-9741.20150076
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Application of mechanical ventilation weaning predictors after elective cardiac surgery

Abstract: OBJECTIVETo test several weaning predictors as determinants of successful extubation after elective cardiac surgery.METHODSThe study was conducted at a tertiary hospital with 100 adult patients undergoing elective cardiac surgery from September to December 2014. We recorded demographic, clinical and surgical data, plus the following predictive indexes: static compliance (Cstat), tidal volume (Vt), respiratory rate (f), f/ Vt ratio, arterial partial oxygen pressure to fraction of inspired oxygen ratio (PaO2/FiO… Show more

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Cited by 5 publications
(11 citation statements)
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“…The doctor was responsible for checking daily ( 1 - 3 , 5 , 11 - 16 ) if the reason for IMV instauration was solved or if there was any improvement ( 2 , 5 , 7 - 8 , 11 - 12 , 14 , 17 - 21 ) by clinical evaluation, chest x-ray, arterial blood gasometry or any necessary diagnostic test. In addition, a series of criteria for disconnection ( 1 , 5 , 9 , 17 ) of MV were evaluated, which the patient had to accomplish completely in order to progress within the protocol:a) Respiratory stability: Blood pressure of oxygen (PO2) ≥ 60 mmHg5 , 7 , 14 , 18 , 22 with inspired oxygen fraction (FiO2) ≤ 0.4 ( 5 , 10 , 14 , 16 , 19 , 21 - 22 ) ; respiratory rate (RR) < 35 respirations per minute ( 5 , 19 , 22 - 23 ) and positive end-expiratory pressure level (PEEP) ≤ 5-8 cm H2O ( 2 , 5 , 7 , 9 - 11 , 13 - 14 , 19 , 21 , 24 - 26 ) .b) Hemodynamic stability with stable cardiovascular function ( 5 , 14 , 16 , 22 - 23 ) , heart rate (HR) < 120 beats per minute ( 5 , 7 - 8 ) and no need for vasoactive drugs or a minimum amount ( 2 , 5 , 7 - 8 , 11 , 13 , 18 , 20 - 23 ) , accepting doses of less than 5µ/kg/min of dobutamine ( 2 , 5 , 7 , 19 , 22 , 25 ) and <0.1µg/kg/min of noradrenaline.c) Neurological Stability: Glasgow Coma Scale (GCS) ≥ 9 ( 5 , 18 ) and between -2 and 0 ( 5 , …”
Section: Methodsmentioning
confidence: 99%
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“…The doctor was responsible for checking daily ( 1 - 3 , 5 , 11 - 16 ) if the reason for IMV instauration was solved or if there was any improvement ( 2 , 5 , 7 - 8 , 11 - 12 , 14 , 17 - 21 ) by clinical evaluation, chest x-ray, arterial blood gasometry or any necessary diagnostic test. In addition, a series of criteria for disconnection ( 1 , 5 , 9 , 17 ) of MV were evaluated, which the patient had to accomplish completely in order to progress within the protocol:a) Respiratory stability: Blood pressure of oxygen (PO2) ≥ 60 mmHg5 , 7 , 14 , 18 , 22 with inspired oxygen fraction (FiO2) ≤ 0.4 ( 5 , 10 , 14 , 16 , 19 , 21 - 22 ) ; respiratory rate (RR) < 35 respirations per minute ( 5 , 19 , 22 - 23 ) and positive end-expiratory pressure level (PEEP) ≤ 5-8 cm H2O ( 2 , 5 , 7 , 9 - 11 , 13 - 14 , 19 , 21 , 24 - 26 ) .b) Hemodynamic stability with stable cardiovascular function ( 5 , 14 , 16 , 22 - 23 ) , heart rate (HR) < 120 beats per minute ( 5 , 7 - 8 ) and no need for vasoactive drugs or a minimum amount ( 2 , 5 , 7 - 8 , 11 , 13 , 18 , 20 - 23 ) , accepting doses of less than 5µ/kg/min of dobutamine ( 2 , 5 , 7 , 19 , 22 , 25 ) and <0.1µg/kg/min of noradrenaline.c) Neurological Stability: Glasgow Coma Scale (GCS) ≥ 9 ( 5 , 18 ) and between -2 and 0 ( 5 , …”
Section: Methodsmentioning
confidence: 99%
“…In addition, a series of criteria for disconnection ( 1 , 5 , 9 , 17 ) of MV were evaluated, which the patient had to accomplish completely in order to progress within the protocol:a) Respiratory stability: Blood pressure of oxygen (PO2) ≥ 60 mmHg5 , 7 , 14 , 18 , 22 with inspired oxygen fraction (FiO2) ≤ 0.4 ( 5 , 10 , 14 , 16 , 19 , 21 - 22 ) ; respiratory rate (RR) < 35 respirations per minute ( 5 , 19 , 22 - 23 ) and positive end-expiratory pressure level (PEEP) ≤ 5-8 cm H2O ( 2 , 5 , 7 , 9 - 11 , 13 - 14 , 19 , 21 , 24 - 26 ) .b) Hemodynamic stability with stable cardiovascular function ( 5 , 14 , 16 , 22 - 23 ) , heart rate (HR) < 120 beats per minute ( 5 , 7 - 8 ) and no need for vasoactive drugs or a minimum amount ( 2 , 5 , 7 - 8 , 11 , 13 , 18 , 20 - 23 ) , accepting doses of less than 5µ/kg/min of dobutamine ( 2 , 5 , 7 , 19 , 22 , 25 ) and <0.1µg/kg/min of noradrenaline.c) Neurological Stability: Glasgow Coma Scale (GCS) ≥ 9 ( 5 , 18 ) and between -2 and 0 ( 5 , 18 ) on the Richmond Scale ( 27 ) to ensure a low level of sedation ( 2 , 5 , 11 , 15 , 19 ) .d) Absence of fever ( 5 , 7 , 16 , 20 , 22 ) or hypothermia ( 5 , 16 ) , presence of cough reflex ( 2 , 5 , …”
Section: Methodsmentioning
confidence: 99%
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