The prediction of extubation success of postoperative neurosurgical patients using frequency-tidal volume ratios

The prediction of extubation success of postoperative neurosurgical patients using frequency-tidal volume ratios

Autor Vidotto, Milena C. Autor UNIFESP Google Scholar
Sogame, Luciana C. M. Google Scholar
Calciolari, Christiane C. Autor UNIFESP Google Scholar
Nascimento, Oliver A. Autor UNIFESP Google Scholar
Jardim, Jose R. Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
EMESCAM
Resumo Background the process of discontinuing neurological patients from mechanical ventilation is still controversial. the aim of this study was to report the outcome from extubating patients undergoing elective craniotomy and correlate the result with the measured f/V(t) ratio.Materials and Methods in a cohort prospective study, all consecutive patients who required mechanical ventilation for up to 6 h after elective craniotomy were eligible for inclusion in this study. Patients passing daily screening criteria automatically received a spontaneous breathing trial (SBT). Immediately previous to the extubation, the expired minute volume (VE), breathing frequency (f), and tidal volume (V(t)) were measured and the breathing frequency-to-tidal volume ratio (f/V(t)) was calculated; consciousness level based on Glasgow Coma Scale (GCS) was evaluated at the same time. the extubation was considered a failure when patients needed reintubation within 48 h.Results Ninety-two patients were extubated and failure occurred in 16%. Despite 15 patients failed extubation just one of them presented the f/V(t) score over 105. the best cutoff value for f/V(t) observed was 62, but with low specificity (0.53) and negative predictive values (0.29). Area under the ROC curve for the f/V(t) was 0.69 +/- 0.07 (P = 0.02). Patients who failed the extubation process presented higher incidence of pneumonia (80%), higher need for tracheostomy (33%) and mortality rate of 40%.Conclusion the f/V(t) ratio does not predict extubation failure in patients who have undergone elective craniotomy. Patients who fail extubation present higher incidence of pneumonia, tracheostomy and higher mortality rate.
Palavra-chave ventilator weaning
mechanical ventilation
neurosurgery
craniotomy
weaning failure
frequency-tidal volu me ratio
Idioma Inglês
Data de publicação 2008-08-01
Publicado em Neurocritical Care. Totowa: Humana Press Inc, v. 9, n. 1, p. 83-89, 2008.
ISSN 1541-6933 (Sherpa/Romeo, fator de impacto)
Publicador Humana Press Inc
Extensão 83-89
Fonte http://dx.doi.org/10.1007/s12028-008-9059-x
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000258657500012
Endereço permanente http://repositorio.unifesp.br/handle/11600/30817

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