The Rothman Index Does Not Predict a Successful Extubation in the Neurosurgical Critical Care Unit
| Autor: | Justin Johal, Shaheryar Hafeez, Ali Seifi, Mouhamed Nashawi, Mohammed T Al-Hamaydeh, Abdullah Ghali, Josh Learned |
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| Rok vydání: | 2021 |
| Předmět: |
extubation
neuro-critical care Pulmonology business.industry medicine.medical_treatment General Engineering Neurointensive care Healthcare Technology reintubation Intensive care unit intubation law.invention Neurology law Anesthesia Cohort Rapid shallow breathing index Cuff medicine Intubation Airway management rothman index Airway business |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| Popis: | Background Identification of risk factors associated with successful extubation in neurosurgical critical care units (NSICUs) has been elusive due to the complex nature of neurocritical care injuries and patient factors. Traditional risk factors for extubation were shown to have poor predictive value in neurocritical care patients as compared to mixed ICU patients. The aim of this study was to determine if any risk factors, including the Rothman Index, could reliably predict successful extubation in a large sample size of neurocritical care patients. Methods We retrospectively analyzed 610 consecutively intubated patients in an NSICU while collecting variables of interest in airway management. Furthermore, Rothman Indices were collected immediately after intubations and extubations. A paired t-test of the immediate changes in Rothman Indices after airway manipulation was compared in patients who needed reintubation. In a smaller cohort of 88 patients, in whom complete data points existed for airway management, we performed a principal component analysis (PCA) to determine which risk factors were associated with extubation success when indexed with the magnitude of the Rothman Index. Results In 610 consecutively intubated patients, the mean pre-intubation Rothman Index average was 41.0 compared to the mean post-extubation Rothman Index was 35.4 (p |
| Databáze: | OpenAIRE |
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