Scholarlink

Background <p>The process of discontinuing mechanical ventilation constitutes a major clinical challenge, especially in patients with respiratory diseases. A large spectrum of weaning predictors has been studied<b>. </b></p> Aim <p>To compare two methods for estimating minute ventilation recovery time and to ascertain which method is more reliable in predicting weaning success.</p> Patients and methods <p>A prospective cohort study was conducted on mechanically ventilated patients during the period of the study. Detailed medical history and routine laboratory investigations were documented for all patients. Maximum inspiratory pressure (P<sub>IMax</sub>), rapid shallow breathing index (RSBI), airway occlusion pressure (P0.1), and CROP (Compliance, Rate, Oxygenation, and Pressure) index were recorded. Minute ventilation recovery time (MVRT) was recorded by two different methods. After fulfilling the weaning criteria, a spontaneous breathing trial (SBT) was performed. Patients who tolerated a SBT without signs of distress were extubated.</p> Results <p>300 mechanically ventilated patients were recruited. The mean age was 57.08 ± 8.11 years, 53% were males. Associated comorbidities included ischemic heart disease (15.3%), diabetes mellitus (38.3%), and hypertension (34.7%).66.7% reported extubation success, while 33.3% failed in extubation. MVRT1,MVRT2,and RSBI were significantly higher in the failure group (p&lt;0.001). Additionally, simplified acute physiology scores (SAPS) were significantly elevated in the failure group. Receiver operating characteristic (ROC) curve analysis demonstrated that both MVRT1 and MVRT2 were strong predictors of weaning success. MVRT1 at a cutoff value of ≤9 minutes exhibited excellent predictive performance, with an area under the curve (AUC) of 0.990 (95% CI: 0.971–0.998), sensitivity of 100%, specificity of 99%, and overall accuracy of 99.7%.MVRT2 at a cutoff value of ≤11.5 hours had good predictive performance, with an AUC of 0.911 (95% CI: 0.873–0.941), sensitivity of 84.5%, specificity of 87%, and accuracy of 85.3%.In the model including MVRT1, independent predictors of success were lower MVRT1 (OR=0.220, 95% CI: 0.119–0.405, p&lt;0.001) and lower RSBI (OR=0.950, 95% CI: 0.913–0.989, p=0.013). This model showed excellent performance (Nagelkerke R²=0.962, overall model accuracy 99.7%).</p> Conclusions <p>The minute ventilation recovery time measured by the first method showed higher accuracy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Assessment of minute ventilation recovery time as a predictor of weaning outcomes: comparison of two methods

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月11日

查看全文
  • Ahmad Abbas,
  • Hadeer Ahmed Elshahaat,
  • Ashraf El Sayed Ahmed,
  • Mohammad Walaa

摘要

Background

The process of discontinuing mechanical ventilation constitutes a major clinical challenge, especially in patients with respiratory diseases. A large spectrum of weaning predictors has been studied.

Aim

To compare two methods for estimating minute ventilation recovery time and to ascertain which method is more reliable in predicting weaning success.

Patients and methods

A prospective cohort study was conducted on mechanically ventilated patients during the period of the study. Detailed medical history and routine laboratory investigations were documented for all patients. Maximum inspiratory pressure (PIMax), rapid shallow breathing index (RSBI), airway occlusion pressure (P0.1), and CROP (Compliance, Rate, Oxygenation, and Pressure) index were recorded. Minute ventilation recovery time (MVRT) was recorded by two different methods. After fulfilling the weaning criteria, a spontaneous breathing trial (SBT) was performed. Patients who tolerated a SBT without signs of distress were extubated.

Results

300 mechanically ventilated patients were recruited. The mean age was 57.08 ± 8.11 years, 53% were males. Associated comorbidities included ischemic heart disease (15.3%), diabetes mellitus (38.3%), and hypertension (34.7%).66.7% reported extubation success, while 33.3% failed in extubation. MVRT1,MVRT2,and RSBI were significantly higher in the failure group (p<0.001). Additionally, simplified acute physiology scores (SAPS) were significantly elevated in the failure group. Receiver operating characteristic (ROC) curve analysis demonstrated that both MVRT1 and MVRT2 were strong predictors of weaning success. MVRT1 at a cutoff value of ≤9 minutes exhibited excellent predictive performance, with an area under the curve (AUC) of 0.990 (95% CI: 0.971–0.998), sensitivity of 100%, specificity of 99%, and overall accuracy of 99.7%.MVRT2 at a cutoff value of ≤11.5 hours had good predictive performance, with an AUC of 0.911 (95% CI: 0.873–0.941), sensitivity of 84.5%, specificity of 87%, and accuracy of 85.3%.In the model including MVRT1, independent predictors of success were lower MVRT1 (OR=0.220, 95% CI: 0.119–0.405, p<0.001) and lower RSBI (OR=0.950, 95% CI: 0.913–0.989, p=0.013). This model showed excellent performance (Nagelkerke R²=0.962, overall model accuracy 99.7%).

Conclusions

The minute ventilation recovery time measured by the first method showed higher accuracy.