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- Title
Studying the Power of the Integrative Weaning Index in Predicting the Success Rate of the Spontaneous Breathing Trial in Patients under Mechanical Ventilation.
- Authors
Ebrahimabadi, Sahar; Moghadam, Ahmad Bagheri; Vakili, Mohammadali; Modanloo, Mahnaz; Khoddam, Homeira
- Abstract
Background and Aims: The use of weaning predictive indicators can avoid early extubation and wrongful prolonged mechanical ventilation. This study aimed to determine the power of the integrative weaning index (IWI) in predicting the success rate of the spontaneous breathing trial (SBT) in patients under mechanical ventilation. Materials and Methods: In this prospective study, 105 patients undergoing mechanical ventilation for over 48 h were enrolled. Before weaning initiation, the IWI was calculated and based on the defned cutoff point (≥25), the success rate of the SBT was predicted. In case of weaning from the device, 2-h SBT was performed and the physiologic and respiratory indices were continuously studied while being intubated. If they were in the normal range besides the patient's tolerance, the test was considered as a success. The result was then compared with the IWI and further analyzed. Results: The SBT was successful in 90 (85.7%) and unsuccessful in 15 (14.3%) cases. The difference between the true patient outcome after SBT, and the IWI prediction was 0.143 according to the Kappa agreement coeffcient (P < 0.001). Moreover, regarding the predictive power, IWI had high sensitivity (95.6%), specificity (40%), positive and negative predictive values (90.5% and 60), positive and negative likelihood ratios (1.59 and 0.11), and accuracy (86.7%). Conclusion: The IWI as a more objective indicator has acceptable accuracy and power for predicting the 2-h SBT result. Therefore, in addition to the reliable prediction of the final weaning outcome, it has favorable power to predict if the patient is ready to breathe spontaneously as the first step to weaning.
- Subjects
EVALUATION of medical care; STATISTICS; EXPERIMENTAL design; CONFIDENCE intervals; RESEARCH evaluation; MECHANICAL ventilators; PATIENTS; ARTIFICIAL respiration; COMPARATIVE studies; GLASGOW Coma Scale; DESCRIPTIVE statistics; LOGISTIC regression analysis; ODDS ratio; SENSITIVITY &; specificity (Statistics); LONGITUDINAL method; POWER (Social sciences); SUCCESS; PROBABILITY theory
- Publication
Indian Journal of Critical Care Medicine, 2017, Vol 21, Issue 8, p488
- ISSN
0972-5229
- Publication type
Article
- DOI
10.4103/ijccm.IJCCM_10_17