Características definidoras da Resposta Disfuncional ao Desmame Ventilatório como indicadores de acurácia do desmame ventilatório

Abstract

The study aimed to analyze the defining characteristics of the Dysfunctional Ventilatory Weaning Response as an indicator of the accuracy of ventilatory weaning. Observational study of 38 events of ventilatory weaning in adult patients admitted to intensive care. For the defining characteristics, it was calculated: sensitivity, specificity, positive and negative predictive values, accuracy or efficiency, likelihood ratio positive and negative, and diagnostic odds ratio. It was also considered the median number of defining characteristics in the event of success and failure. It was considered accurate: agitation, deterioration in arterial blood gases from baseline parameters, moderate use of accessory muscles of respiration, increased respiratory rate from baseline parameters and respiratory rate increases significantly with respect to baseline parameters. There was statistical difference in the median number of defining characteristics observed. It was concluded that the defining characteristic and the number of them would influence the success of the weaning decision.

Use of clinical simulation to improve diagnostic reasoning in nursing

“…For some nursing diagnoses, one characteristic that defines it is sufficient, but others require at least three to four or even six for an accurate judgment. 22 When seeking to make the reasoning model more complex or deepen the discussion in debriefing, other measurements can be incorporated when selecting the defining characteristics, such as: likelihood ratio, predictive values, and accuracy or efficiency, 19 which requires conceptual knowledge of what each statistical information represents in clinical validation studies, but the benefits can be significant and contribute to the production of more adequate cases and simulations to the development of reasoning that is compatible with dual processing.…”

Teste de respiração espontânea como preditor da Resposta disfuncional ao desmame ventilatório em terapia intensiva

“…8 Um estudo na enfermagem que acompanhou o desmame durante a realização de TRE por 120 minutos verificou que a taxa de insucesso foi de 47,3% do total de casos acompanhados. 9 Portanto, avaliar e estimar o sucesso do desmame ventilatório é um desafio, como o monitoramento das respostas ao processo.…”