Evaluation of some predictors for successful weaning from mechanical ventilation

Mabrouk, Ali A.; Mansour, Osama; El-Aziz, Aml A. Abd; El-Habashy, Mahmoud M.; Alasdoudy, Ahmed

doi:10.1016/j.ejcdt.2015.03.021

Cited by 14 publications

(6 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…According to the evidence, several demographic, and clinical parameters can influence the patients' success rates of weaning (16). The weaning method used can also affect the failure rate (17). Boniatti and others suggested positive fluid balance and serum levels of hemoglobin and bicarbonate as predictors of weaning failure and re-intubation (15), which is contrary to the results of our study, as we found no significant difference between the patients with successful and failed weaning in terms of Sat.O2, blood pressure, serum levels of hemoglobin, and PH, while the only significant variables were presented as mean GCS, duration of hospital admission, ventilation, and PWT score, and the patients with unsuccessful results had a lower GCS, higher duration of hospital stay and ventilation, as well as lower scores of PWT.…”

Section: Discussioncontrasting

confidence: 98%

The Value of Persian Weaning Tool in Prediction of Patients’ Weaning Outcome Compared with Physician- Directed Approach: A Diagnostic Accuracy Study

Mirzaali

Vakili

Khoddam

2020

J Res Dev Nurs Midw

View full text Add to dashboard Cite

Background: One of the important criteria in patients receiving artificial respiration is the time of weaning from the mechanical ventilator. As physician's decision might be somehow subjective, several tools have been suggested for prediction of the time of weaning more objectively. This study aimed to determine the predictive value of Persian Weaning Tool (PWT) compared with Physician-directed approach as the gold standard. Methods: This diagnostic accuracy study was done in 2016-2017 in Two Medical and Educational Centers of Gorgan, Iran. 97 admitted patients in intensive care units, under mechanical ventilation were evaluated. The patients were recruited into the study by a convenience sampling method and evaluated for readiness to wean using two approaches (physician's decision and using PWT). Successful weaning was considered as the ability of patient to breathe spontaneously during the first 48 hours after weaning. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR), as well as the agreement (kappa coefficient) between the two approaches, were calculated. In addition, to compare the differences between variables in two groups, chi-Square, T and man-Whitney tests were used. All analyses were performed using SPSS software ver.16, and MedCalc program ver.13. P<0.05 was considered as statistically significant. Results: Most patients (64.9%) were men. The mean age, duration of hospital admission, and

show abstract

Section: Discussioncontrasting

confidence: 98%

The Value of Persian Weaning Tool in Prediction of Patients’ Weaning Outcome Compared with Physician- Directed Approach: A Diagnostic Accuracy Study

Mirzaali

Vakili

Khoddam

2020

J Res Dev Nurs Midw

View full text Add to dashboard Cite

show abstract

“…However, PI max still needs a cooperative patient and maximal respiratory effort other than diaphragmatic displacement measured in quiet breathing [6]. In contrast, Mabrouk et al [11], who evaluated some predictors for successful weaning from mechanical ventilation using different weaning modes, found no significant difference between the two groups as regards PI max, which may be because mechanically ventilated patients with nonrespiratory causes were included in his study; moreover, the weaning methods from mechanical ventilation were different in each group and the number of the patients was different.…”

Section: Discussionmentioning

confidence: 99%

Role of ultrasound in assessment of diaphragmatic function in chronic obstructive pulmonary disease patients during weaning from mechanical ventilation

et al. 2016

View full text Add to dashboard Cite

ObjectivesThe aim of the study was to investigate the role of ultrasound in the evaluation of movement of the diaphragm and its value in predicting successful extubation in mechanically ventilated chronic obstructive pulmonary disease (COPD) patients in relation to other weaning parameters. Patients and methodsThe present study was conducted on 50 patients in the respiratory ICU and the Chest Department of Ain Shams University Hospitals. Patients were divided into two groups: group A and group B. Group A consisted of 30 mechanically ventilated COPD patients admitted to the respiratory ICU and group B consisted of 20 COPD patients not mechanically ventilated during attendance at the Chest Department. ResultsDiaphragmatic movement was assessed in the two groups. The mean value of diaphragmatic displacement was higher in group B. In group A this value was higher among those with successful weaning using a cutoff value of 1.1 cm with sensitivity of 86.4%, specificity of 87.5%, and accuracy of 89.5%. There was a significant correlation between diaphragmatic displacement and other weaning parameters, which was better in the group with successful weaning. Conclusion Diaphragmatic displacement measuredby ultrasound is one of the most sensitive, specific, and accurate parameters for weaning of COPD patients from mechanical ventilation, especially in relationship with other weaning parameters.

show abstract

“…Durante o processo de desmame, os pesquisadores utilizaram, além de outros recursos, o Índice de Tobin e a Pimáx como preditores de sucesso no desmame e, nesse contexto, os autores ressaltam que este critério apresentou grande taxa de falso-positivo para a eficácia deste teste como preditor de sucesso do desmame ventilatório 14 . Nesse contexto, outros estudos 15,16,17,18,19 discordam deste resultado, evidenciando que a Pimáx e o Índice de Tobin possuem alta especificidade como preditor para desmame.…”

Section: Discussionunclassified

Análise da influência da pressão inspiratória máxima e do índice de Tobin no sucesso do desmame ventilatório através do teste de respiração espontânea

Lins,

Siqueira,

Dias

et al. 2023

Braz. J. Develop.

View full text Add to dashboard Cite

Pacientes internados na unidade de terapia intensiva (UTI) em sua maioria necessitam de alguma forma de suporte ventilatório invasivo, através de tubo orotraqueal (TOT) ou cânula de traqueostomia (TQT). Quando há resolução do quadro, a retirada precoce do suporte ventilatório torna-se um dos principais objetivos da equipe multiprofissional, porém não é sempre uma tarefa fácil. Protocolos para desmame da ventilação mecânica invasiva (VMI) são válidos a fim de minimizar os riscos de falha do desmame ao paciente. Objetivo: Determinar o índice de sucesso e insucesso da extubação com a aplicação de dois tipos de protocolos de desmame ventilatório. Metodologia: Trata-se de um estudo prospectivo, analítico e longitudinal, realizado em duas UTI’s adulto com indivíduos submetidos a VMI por meio de TOT a mais de 24 horas. Os pacientes foram divididos em 2 grupos, em G-1 (pacientes da UTI 1) em que foi utilizado o TRE convencional; e o G-2 (pacientes da UTI 2), com o TRE em adição do índice de Tobin e a Pressão Inspiratória Máxima (Pimáx). Resultados: Foram selecionados 20 pacientes divididos em 2 grupos, o índice de Tobin e Pimáx, avaliados somente no G-2, foram de 42,8±20,3 e -36,0±17,4, respectivamente e apenas o G-1, com 20% (n=2) da amostra apresentou falha de extubação. Conclusão: Conclui-se que na amostra estudada, o índice de Tobin e Pimáx não apresentaram especificidade significativa como preditores de desmame da VMI, este fato pode ter sido ocasionado devido a fatores como, o tamanho curto da amostra ou a heterogeneidade dela.

show abstract

Evaluation of some predictors for successful weaning from mechanical ventilation

Cited by 14 publications

References 7 publications

The Value of Persian Weaning Tool in Prediction of Patients’ Weaning Outcome Compared with Physician- Directed Approach: A Diagnostic Accuracy Study

The Value of Persian Weaning Tool in Prediction of Patients’ Weaning Outcome Compared with Physician- Directed Approach: A Diagnostic Accuracy Study

Role of ultrasound in assessment of diaphragmatic function in chronic obstructive pulmonary disease patients during weaning from mechanical ventilation

Análise da influência da pressão inspiratória máxima e do índice de Tobin no sucesso do desmame ventilatório através do teste de respiração espontânea

Contact Info

Product

Resources

About