Role of Integrated Pulmonary Index in Identifying Extubation Failure

Kaur, Ramandeep; Vines, David; Liu, Li; Balk, R.A.

doi:10.4187/respcare.05434

Cited by 17 publications

(15 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, all clinicians may use IPI score in order to determine which patients need additional clinical assessment and intervention (12,16). IPI is demonstrated as a single indexed value from 1 to 10, where 8-10 shows a nearly normal ventilation, whereas a level ≤ 6 shows that intervention might be required, and a level ≤4 shows that intervention is ultimately necessary (11,16,32). Although, CTPA is the current gold standard diagnostic method, it may not be practical to employ it in all patients who were admitted to EDs with dys- pnea and suspected PE (33,34).…”

Section: Discussionmentioning

confidence: 99%

Performance of integrated pulmonary index for pulmonary embolism in dyspneic patients

Akbas¹,

Koçak²,

Çelik³

et al. 2021

BLL

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Performance of integrated pulmonary index for pulmonary embolism in dyspneic patients

Akbas¹,

Koçak²,

Çelik³

et al. 2021

BLL

View full text Add to dashboard Cite

“…We are hoping to find a drug regimen that can maintain a moderate depth of anesthesia and, most importantly, ensure that breathing is not affected, which is a very challenging problem [ 19 , 20 ]. The IPI index is a new tool approved by the FDA to reflect the respiratory state of patients during sedation [ 21 ]. It is a comprehensive index based on four physiological parameters: etCO 2 , RR, SPO 2 and PR.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Remimazolam Besylate Combined with Alfentanil in Painless Gastroscopy: A Randomized, Single‐Blind, Parallel Controlled Study

Chen

Ren

et al. 2022

Contrast Media & Molecular Imaging

View full text Add to dashboard Cite

Background. The efficacy and adverse reactions of remimazolam besylate (RB) in combination with alfentanil in patients with painless gastroscopy remain unclear. Objective. The aim of the study is to observe the efficacy and adverse reactions of RB in combination with alfentanil in patients with painless gastroscopy RB. Methods. All patients were randomly divided into two groups: RB combined with the alfentanil group (research group) and propofol combined with the alfentanil group (control group). After full oxygen inhalation and electrocardiographic monitoring, the research group was given 10 μg/Kg alfentanil + RB 0.2 mg/kg intravenously, and the control group was given 10 μg/Kg alfentanil + propofol 1.5 mg/kg. If there is a clinical need, the research group was given 2.5 mg/additional RB, whereas the control group was treated with an additional 0.5 mg/kg propofol. Main outcome measures were as follows: The vital endpoints including diachronic changes in heart rate (HR), blood pressure (BP), respiratory rate (RR), blood oxygen saturation (SPO2), end-expiratory carbon dioxide (etCO2), IPI, modified observer’s assessment of alert/sedation (MOAA/S), time-related endpoints, perioperative adverse events, endoscopy, and anesthesiologist satisfaction, and 24-hour follow-up of adverse reactions, IPI scores, and satisfaction were recorded. Results. The HR and BP of the patients in the research group and the control group decreased, with a greater decrease in the control group, and the difference was statistically significant ( p < 0.05). The values of RR, PETCO2, and IPI in the research group and the control group decreased to the lowest at 2–3 min but the decrease in the control group was more significant. Furthermore, there was no significant difference in the time from the completion of administration to 4 minutes of IPI and the total examination time, but the awakening time in the research group was slightly longer than that in the control group, and the difference was statistically significant ( p < 0.05). The incidences of respiratory depression and hypotension during the operation were shown to be markedly smaller in the investigation relative to the control team, and the difference was statistically significant ( p < 0.05), whereas the occurrence of cough, movements, and singultus was more common in the investigations, and the difference was statistically significant ( p < 0.05). The results of the 24-hour follow-up showed that the adverse reactions such as nausea, dizziness, fatigue, abdominal pain, and abdominal distension were much less frequent in the study team, and the difference was statistically significant ( p < 0.05), and the patient satisfaction was higher than in the control group, and the difference was statistically significant ( p < 0.05). The regression results showed that age, sedative, and total dose of analgesia had significant effects on the results, and the covariance coefficient of sedative was 1.57 of IPI score in the research group higher than that of the control group. Conclusions. RB combined with alfentanil can provide safe and effective sedation for patients undergoing painless gastroscopy. Compared with propofol, RB and alfentanil for injection can avoid large hemodynamic fluctuations and deep sedation, and have fewer adverse reactions. However, the cases involved in this study are all from a single-center data, which requires further multicenter research and conformation.

show abstract

“…Na amostra estudada, mesmo sendo uma população com diversos diagnósticos, o principal era neurológico, e o os pacientes do sexo masculino foram a maioria reintubados por insuficiência respiratória (40,63%). Em um estudo de Kaur, Vines, Liu, & Balk (2017), no qual foram levantadas as características dos pacientes internados em 17 unidades de terapia intensiva médico-cirúrgica espanholas, que foram submetidos a reintubação, a média de idade foi de 63 anos, os homens representaram 43,5% e as mulheres 56,5% dos pacientes, outro achado semelhante ao presente estudo, onde a média de idade foi de 69 para sexo feminino e 64 para sexo masculino, e também foi predominante pacientes do sexo feminino (55,17%).…”

Section: Discussionunclassified

Principais Causas De Falha Na Extubação De Pacientes Internados Em Um Centro De Terapia Intensiva Adulto De Um Hospital Do Interior De Minas Gerais

Fonseca

Nogueira

Machado³

2020

Psicodebate

View full text Add to dashboard Cite

A ventilação mecânica (VM) ou suporte ventilatório é considerado um método de tratamento vital nas (UTIs). Ademais é tido como um valioso suporte no atendimento de paciente com insuficiência respiratória aguda e crônica agudizada. Há evidências de que, quanto antes seja estabelecida a condição clínica desse paciente, de acordo como protocolo mais breve será a sua extubação. O objetivo dessa pesquisa foi determinar as principais causas de falha na extubação em pacientes de um centro de terapia intensiva adulto (CTI). O estudo realizado foi do tipo descritivo, retrospectivo e longitudinal, foram analisados 58 prontuários de pacientes que estiveram internados no CTI de um hospital do interior de Minas Gerais. A amostra foi composta por 58 pacientes, sendo 32 homens e 26 mulheres, desses 23 foram a óbito. O principal diagnóstico clínico foi doenças neurológicas seguida de doenças respiratórias. A principal causa de falha da extubação no sexo feminino foi por laringoespasmo; aumento do trabalho respiratório; e rebaixamento do nível de consciência associado ao aumento do trabalho respiratório. No sexo masculino foi por insuficiência respiratória; rebaixamento do nível de consciência associado ao aumento do trabalho respiratório. O estudo, perfez-se que dos prontuários analisados 23 destes evoluíram para óbito. O tempo que o paciente permaneceu em ventilação mecânica corresponde a 5 dias. Nove pacientes do sexo feminino e seis do sexo masculino, foram considerados inaptos pelo protocolo e extubados, destes, 5 pacientes evoluíram para óbito, o que mostra a falta de adesão, e a resistência da equipe em seguir protocolos.

show abstract

Role of Integrated Pulmonary Index in Identifying Extubation Failure

Abstract: Declining IPI measurements postextubation are predictive of extubation failure. Further clinical trials are needed to assess the role of IPI in guiding interventions in extubated patients.

Cited by 17 publications

References 21 publications

Performance of integrated pulmonary index for pulmonary embolism in dyspneic patients

Performance of integrated pulmonary index for pulmonary embolism in dyspneic patients

Efficacy and Safety of Remimazolam Besylate Combined with Alfentanil in Painless Gastroscopy: A Randomized, Single‐Blind, Parallel Controlled Study

Principais Causas De Falha Na Extubação De Pacientes Internados Em Um Centro De Terapia Intensiva Adulto De Um Hospital Do Interior De Minas Gerais

Contact Info

Product

Resources

About