Peripheral perfusion index as a predictor of failed weaning from mechanical ventilation
| Autor: | Ahmed Zaghloul Fouad, Dalia Saad, Ahmed Lotfy, Ahmed Hasanin, Walid Hamimy, Mahitab Rashad, M. A. Mahmoud, Maha Mostafa |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Health Informatics Weaning Critical Care and Intensive Care Medicine Spontaneous breathing trial 03 medical and health sciences Mechanical ventilation 0302 clinical medicine Peripheral perfusion 030202 anesthesiology Anesthesiology Intubation Intratracheal Humans Medicine Critically ill Original Research Receiver operating characteristic business.industry 030208 emergency & critical care medicine Respiration Artificial Confidence interval Perfusion Index Clinical trial Peripheral perfusion index Anesthesiology and Pain Medicine Anesthesia Airway Extubation business Ventilator Weaning |
| Zdroj: | Journal of Clinical Monitoring and Computing |
| ISSN: | 1573-2614 1387-1307 |
| DOI: | 10.1007/s10877-020-00483-1 |
| Popis: | We hypothesized that impairment of peripheral perfusion index (PPI) during spontaneous breathing trial (SBT) might be predictive of weaning failure. We included 44 consecutive, adult, patients, who were scheduled for weaning after at least 48 h of invasive mechanical ventilation in this prospective observational study. Weaning failure was defined as failed SBT or reintubation within 48 h of extubation. PPI readings were obtained before initiation of the SBT, and every 5 min till the end of the SBT. PPI ratio was calculated at every time point as: PPI value/ baseline PPI. The primary outcome was the accuracy of PPI ratio at the end of the SBT in detecting failed weaning. Forty-three patients were available for the final analysis. Eighteen patients (42%) were considered failed weaning. PPI ratio was higher in patients with successful weaning compared to patients with failed weaning during the last 15 min of the SBT. PPI ratio at the end of SBT was higher in patients with successful weaning compared to patients with failed weaning. PPI ratio at the end of SBT had good predictive ability for weaning failure {area under receiver operating characteristic curve (95% confidence interval): 0.833(0.688–0.929), cutoff value ≤ 1.41}. The change in PPI during SBT is an independent predictor for re-intubation. PPI could be a useful tool for monitoring the patient response to SBT. Patients with successful weaning showed higher augmentation of PPI during the SBT compared to re-intubated patients. Failure of augmenting the PPI by 41% at the end of SBT could predict re-intubation with negative predictive value of 95%. Clinical trial identifier: NCT03974568. https://clinicaltrials.gov/ct2/show/NCT03974568?term=ahmed+hasanin&draw=3&rank=17 |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink