A Decision for Predicting Successful Extubation of Patients in Intensive Care Unit

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2018 Mar 8

PMID 29511690

Citations 7

Authors

Chang-Shu Tu

Chih-Hao Chang

Shu-Chin Chang

Chung-Shu Lee

Ching-Ter Chang

Affiliations

Soon will be listed here.

Abstract

Approximately 40% of patients admitted to the medical intensive care unit (ICU) require mechanical ventilation. An accurate prediction of successful extubation in patients is a key clinical problem in ICU due to the fact that the successful extubation is highly associated with prolonged ICU stay. The prolonged ICU stay is also associated with increasing cost and mortality rate in healthcare system. This study is retrospective in the aspect of ICU. Hence, a total of 41 patients were selected from the largest academic medical center in Taiwan. Our experimental results show that predicting successful rate of 87.8% is obtained from the proposed predicting function. Based on several types of statistics analysis, including logistic regression analysis, discriminant analysis, and bootstrap method, three major successful extubation predictors, namely, rapid shallow breathing index, respiratory rate, and minute ventilation, are revealed. The prediction of successful extubation function is proposed for patients, ICU, physicians, and hospital for reference.

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References

Sassoon C, Mahutte C . Airway occlusion pressure and breathing pattern as predictors of weaning outcome. Am Rev Respir Dis. 1993; 148(4 Pt 1):860-6. DOI: 10.1164/ajrccm/148.4_Pt_1.860. View

Braun M, Oswald F . Exploratory regression analysis: a tool for selecting models and determining predictor importance. Behav Res Methods. 2011; 43(2):331-9. DOI: 10.3758/s13428-010-0046-8. View

Sellares J, Ferrer M, Cano E, Loureiro H, Valencia M, Torres A . Predictors of prolonged weaning and survival during ventilator weaning in a respiratory ICU. Intensive Care Med. 2011; 37(5):775-84. DOI: 10.1007/s00134-011-2179-3. View

Boles J, Bion J, Connors A, Herridge M, Marsh B, Melot C . Weaning from mechanical ventilation. Eur Respir J. 2007; 29(5):1033-56. DOI: 10.1183/09031936.00010206. View

Nava S, Rubini F, Zanotti E, Ambrosino N, Bruschi C, Vitacca M . Survival and prediction of successful ventilator weaning in COPD patients requiring mechanical ventilation for more than 21 days. Eur Respir J. 1994; 7(9):1645-52. DOI: 10.1183/09031936.94.07091645. View

Santus P, Russo A, Madonini E, Allegra L, Blasi F, Centanni S . How air pollution influences clinical management of respiratory diseases. A case-crossover study in Milan. Respir Res. 2012; 13:95. PMC: 3511062. DOI: 10.1186/1465-9921-13-95. View

Mokhlesi B, Tulaimat A, Gluckman T, Wang Y, Evans A, Corbridge T . Predicting extubation failure after successful completion of a spontaneous breathing trial. Respir Care. 2007; 52(12):1710-7. View

MacIntyre N, Epstein S, Carson S, Scheinhorn D, Christopher K, Muldoon S . Management of patients requiring prolonged mechanical ventilation: report of a NAMDRC consensus conference. Chest. 2005; 128(6):3937-54. DOI: 10.1378/chest.128.6.3937. View

de Souza L, Guimaraes F, Lugon J . Evaluation of a new index of mechanical ventilation weaning: the timed inspiratory effort. J Intensive Care Med. 2013; 30(1):37-43. DOI: 10.1177/0885066613483265. View

10.

Kuo H, Chiu H, Lee C, Chen T, Chang C, Bien M . Improvement in the Prediction of Ventilator Weaning Outcomes by an Artificial Neural Network in a Medical ICU. Respir Care. 2015; 60(11):1560-9. DOI: 10.4187/respcare.03648. View

11.

Savi A, Teixeira C, Silva J, Borges L, Pereira P, Pinto K . Weaning predictors do not predict extubation failure in simple-to-wean patients. J Crit Care. 2011; 27(2):221.e1-8. DOI: 10.1016/j.jcrc.2011.07.079. View

12.

Zavorsky G, Cao J, Mayo N, Gabbay R, Murias J . Arterial versus capillary blood gases: a meta-analysis. Respir Physiol Neurobiol. 2006; 155(3):268-79. DOI: 10.1016/j.resp.2006.07.002. View

13.

Newth C, Venkataraman S, Willson D, Meert K, Harrison R, Dean J . Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2008; 10(1):1-11. PMC: 2849975. DOI: 10.1097/PCC.0b013e318193724d. View

14.

Yang P, Hung J, Yang C, Tsai J, Wang T, Lee J . Successful weaning predictors in a respiratory care center in Taiwan. Kaohsiung J Med Sci. 2008; 24(2):85-91. DOI: 10.1016/S1607-551X(08)70102-5. View

15.

Bleeker S, Moll H, Steyerberg E, Donders A, Derksen-Lubsen G, Grobbee D . External validation is necessary in prediction research: a clinical example. J Clin Epidemiol. 2003; 56(9):826-32. DOI: 10.1016/s0895-4356(03)00207-5. View

16.

Farghaly S, Hasan A . Diaphragm ultrasound as a new method to predict extubation outcome in mechanically ventilated patients. Aust Crit Care. 2016; 30(1):37-43. DOI: 10.1016/j.aucc.2016.03.004. View

17.

Murphy R, Thethy S, Raby S, Beckley J, Terrace J, Fiddler C . Capillary blood gases in acute exacerbations of COPD. Respir Med. 2005; 100(4):682-6. DOI: 10.1016/j.rmed.2005.08.007. View

18.

Lee C, Chen N, Chuang L, Chang C, Li L, Lin S . Hypercapnic Ventilatory Response in the Weaning of Patients with Prolonged Mechanical Ventilation. Can Respir J. 2017; 2017:7381424. PMC: 5682900. DOI: 10.1155/2017/7381424. View

19.

El Khoury M, Panos R, Ying J, Almoosa K . Value of the PaO₂:FiO₂ ratio and Rapid Shallow Breathing Index in predicting successful extubation in hypoxemic respiratory failure. Heart Lung. 2010; 39(6):529-36. DOI: 10.1016/j.hrtlng.2009.10.020. View

20.

Zettervall S, Soden P, Shean K, Deery S, Ultee K, Alef M . Early extubation reduces respiratory complications and hospital length of stay following repair of abdominal aortic aneurysms. J Vasc Surg. 2016; 65(1):58-64.e1. PMC: 5183485. DOI: 10.1016/j.jvs.2016.05.095. View