New integrated weaning indices from mechanical ventilation: A derivation-validation observational multicenter study.

Autor:	Vahedian-Azimi A; Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran., Gohari-Moghadam K; Medical ICU and Pulmonary Unit, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran., Rahimi-Bashar F; Anesthesia and Critical Care Department, Hamadan University of Medical Sciences, Hamadan, Iran., Samim A; Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran., Khoshfetrat M; Department of Anesthesiology and Critical Care, Khatamolanbia Hospital, Zahedan University of Medical Sciences, Zahedan, Iran., Mohammadi SM; Department of Anatomical Sciences, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran., de Souza LC; Physical Therapy College, Universidade Estáciode Sá, Rio de Janeiro, Brazil., Mahmoodpoor A; Evidence Based Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2022 Jul 22; Vol. 9, pp. 830974. Date of Electronic Publication: 2022 Jul 22 (Print Publication: 2022).
DOI:	10.3389/fmed.2022.830974
Abstrakt:	Background: To develop ten new integrated weaning indices that can predict the weaning outcome better than the traditional indices. Methods: This retrospective-prospective derivation-validation observational multicenter clinical trial (Clinical Trial.Gov, NCT01779297), was conducted on 1,175 adult patients admitted at 9 academic affiliated intensive care units (ICUs; 4 surgical and 5 medical), from Jan 2013 to Dec 2018. All patients, intubated and mechanically ventilated for at least 24 h and ready for weaning were enrolled. The study had two phases: at first, the threshold values of each index that best discriminate between a successful and an unsuccessful weaning outcome was determined among 208 patients in the derivation group. In the second phase, the predictive performance of these values was prospectively tested in 967 patients in the validation group. In the prospective-validation set we used Bayes' theorem to assess the probability of each test in predicting weaning. Results: In the prospective validation group, sensitivity, specificity, diagnostic accuracy, positive and negative predictive values, and finally area under the receiver operator characteristic curves and standard errors for each index (ten formulae) were calculated. Statistical values of ten formulae for aforesaid variables were higher than 87% (0.87-0.99). Conclusion: The new indices can be used for hospitalized patients in intensive care settings for accurate prediction of the weaning outcome. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Vahedian-Azimi, Gohari-Moghadam, Rahimi-Bashar, Samim, Khoshfetrat, Mohammadi, de Souza and Mahmoodpoor.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu