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PMID: 14608459 Published · ppublish English Clinical Trial Journal Article

Extubation failure: diagnostic value of occlusion pressure (P0.1) and P0.1-derived parameters.

Intensive care medicine ·Vol. 30 ·No. 2 ·2004-02-00 ·Pages 234-240

Fernandez R, Raurich JM, Mut T, Blanco J, Santos A, Villagra A

Abstract

To evaluate the ability of the new, built-in occlusion pressure (P0.1) measurement to predict extubation failure. Prospective observational multicentre study in the ICU of five general hospitals. Hundred thirty patients on mechanical ventilation longer than 48 h when considered ready for weaning. Patients underwent a 30-min spontaneous breathing trial with simultaneous monitoring of occlusion pressure (P0.1) and breathing pattern (f/Vt). Sixteen patients (12%) failed the weaning trial and full ventilatory support was resumed, while 114 tolerated the trial and were extubated. Twenty-one (18%) required reintubation within 48 h. The area under the ROC curve for diagnosing extubation failure was 0.53 for f/Vt, 0.59 for P0.1 and 0.61 for P0.1*f/Vt (p=NS). Accordingly, P0.1*f/Vt more than 100 detected extubation failure with a sensitivity of 0.89, specificity of 0.35, positive predictive value of 0.21 and negative predictive value of 0.94. During a first trial of spontaneous breathing on pressure support ventilation (PSV), bedside P0.1 and P0.1*f/Vt are of little help, if any, for predicting extubation failure.

MeSH Terms
Adult Aged Breathing Exercises Humans Intensive Care Units Middle Aged Postoperative Care/rehabilitation Predictive Value of Tests Prospective Studies Respiration Disorders/rehabilitation,therapy Respiration, Artificial/adverse effects Respiratory Distress Syndrome/rehabilitation,therapy Respiratory Function Tests Time Factors Treatment Outcome Ventilator Weaning
Authors & Affiliations
6 authors, click to expand affiliations / ORCID
Fernandez Rafael
Intensive Care Department, Hospital de Sabadell, Parc Tauli s/n, 08208, Sabadell, Barcelona, Spain. [email protected].
Raurich Juan Maria
Intensive Care Department, Hospital Son Dureta, Andrea Doria 55, 07014, Palma de Mallorca, Spain.
Mut Teresa
Intensive Care Department, Hospital General, Avenida Benicasim s/n, 12004, Castelló de la Plana, Spain.
Blanco Jesus
Intensive Care Department, Hospital Río Hortega, Cardenal Torquemada s/n, 47010, Valladolid, Spain.
Santos Antonio
Intensive Care Department, Complexo Hospitalario Universitario, Rua Ramon Baltar s/n, 15706, Santiago de Compostela, Spain.
Villagra Ana
Intensive Care Department, Hospital de Sabadell, Parc Tauli s/n, 08208, Sabadell, Barcelona, Spain.
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Article Info
Journal
Intensive care medicine
Abbr.
Intensive Care Med
ISSN
0342-4642
DOI
10.1007/s00134-003-2070-y
Email
[email protected]
Published
2004-02-00
Epub
2003-00-08
Pages
234-240
Language
English
Region
United States
NLM ID
7704851
Subset
IM
External Links
PubMed source DOI: 10.1007/s00134-003-2070-y View journal details
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