Evaluation of airway care score as a criterion for extubation in patients admitted in neurosurgery intensive care unit
| Autor: | Anju Grewal, Sandeep Kundra, Udeyana Singh, Ashwani Kumar Chaudhary, Gayatri Tanwar, Sunil Kaytal |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
extubation
medicine.medical_treatment lcsh:RS1-441 law.invention Spontaneous breathing trial lcsh:RD78.3-87.3 lcsh:Pharmacy and materia medica 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology law medicine Pharmacology (medical) General Pharmacology Toxicology and Pharmaceutics Contraindication Mechanical ventilation Airway care score business.industry Glasgow Coma Scale Neurointensive care Glasgow coma scale 030208 emergency & critical care medicine Intensive care unit Anesthesiology and Pain Medicine neurocritical care lcsh:Anesthesiology Anesthesia Observational study business Airway |
| Zdroj: | Journal of Anaesthesiology Clinical Pharmacology, Vol 35, Iss 1, Pp 85-91 (2019) |
| ISSN: | 0970-9185 |
| Popis: | Background and Aims: Early extubation in neurocritical patients has several potential benefits. Glasgow Coma Scale (GCS) is a crude measure of neurologic function in these patients and a low GCS score does not necessarily mean contraindication for extubation. Data on patients with neurosurgical or neurological pathology undergoing early extubation utilizing the airway score criteria is limited. Hence, this study was conceived to assess the usefulness of modified airway care score (ACS) as a criterion for successful extubation of neurocritical patients whilst comparing various outcomes. Material and Methods: One hundred and twenty four patient who underwent endotracheal intubation in the neurocritical care unit were enrolled in this prospective observational study over a period of 12 months. Patients were randomly enrolled into either the study group patients (S), who were extubated immediately after a successful spontaneous breathing trial (SBT) and an ACS ≤7 or into the control group (N), wherein patients were extubated/tracheostomized at discretion of the attending neurointensivist. Both groups were observed for comparison of preset outcomes and analyzed statistically. Results: Patients of study group experienced a statistically significant shorter extubation delay (3.28 h vs 25.41 h) compared to the control group. Successful extubation rate was significantly higher and reintubation rate was significantly lower in study group (6.6% vs 29.3%). Incidence of nosocomial pneumonia, duration of ICU stay and overall duration of mechanical ventilation were significantly lower in the study group. ACS and GCS had a negative correlation at the time of extubation. Conclusion: ACS can be used as a criterion for successful early extubation of neurocritical patients. |
| Databáze: | OpenAIRE |
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