Patients' prediction of extubation success.

Details

Serval ID
serval:BIB_0E32AD3AC8D8
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Patients' prediction of extubation success.
Journal
Intensive Care Medicine
Author(s)
Perren A., Previsdomini M., Llamas M., Cerutti B., Gyoerik S., Merlani G., Jolliet P.
ISSN
1432-1238[electronic], 0342-4642[linking]
Publication state
Published
Issued date
2010
Volume
36
Number
12
Pages
2045-2052
Language
english
Abstract
The spontaneous breathing trial (SBT)-relying on objective criteria assessed by the clinician-is the major diagnostic tool to determine if patients can be successfully extubated. However, little is known regarding the patient's subjective perception of autonomous breathing.
We performed a prospective observational study in 211 mechanically ventilated adult patients successfully completing a SBT. Patients were randomly assigned to be interviewed during this trial regarding their prediction of extubation success. We compared post-extubation outcomes in three patient groups: patients confident (confidents; n = 115) or not (non-confidents; n = 38) of their extubation success and patients not subjected to interview (control group; n = 58).
Extubation success was more frequent in confidents than in non-confidents (90 vs. 45%; p < 0.001/positive likelihood ratio = 2.00) or in the control group (90 vs. 78%; p = 0.04). On the contrary, extubation failure was more common in non-confidents than in confidents (55 vs. 10%; p < 0.001/negative likelihood ratio = 0.19). Logistic regression analysis showed that extubation success was associated with patient's prediction [OR (95% CI): 9.2 (3.74-22.42) for confidents vs.non-confidents] as well as to age [0.72 (0.66-0.78) for age 75 vs. 65 and 1.31 (1.28-1.51) for age 55 vs. 65].
Our data suggest that at the end of a sustained SBT, extubation success might be correlated to the patients' subjective perception of autonomous breathing. The results of this study should be confirmed by a large multicenter trial.
Keywords
Extubation Success, Prediction, Spontaneous Breathing Trial, Mechanical Ventilation, Subjective Impression, Weaning, Pressure Support Ventilation, Spontaneous Breathing Trial, Mechanical Ventilation, Noninvasive Ventilation, Respiratory-Failure, Randomized-Trial, Risk, Reintubation
Pubmed
Web of science
Create date
20/12/2010 10:35
Last modification date
20/08/2019 12:35
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