Studying the power of the integrative weaning index in predicting the success rate of the spontaneous breathing trial in patients under mechanical ventilation

Ebrahimabadi, S. and Moghadam, A. B. and Vakili, M. and Modanloo, M. and Khoddam, H. (2017) Studying the power of the integrative weaning index in predicting the success rate of the spontaneous breathing trial in patients under mechanical ventilation. Indian Journal of Critical Care Medicine, 21 (8). pp. 488-493.

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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 defined 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 coefficient (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.

Item Type: Article
Additional Information: Export Date: 16 February 2020 Correspondence Address: Khoddam, H.; Nursing Research Center, Nursing and Midwifery School, Golestan University of Medical SciencesIran; email: khoddam@goums.ac.ir
Uncontrolled Keywords: Integrative weaning index mechanical ventilation predictive power spontaneous breathing trial artificial ventilation diagnostic test accuracy study female human major clinical study male prediction predictive value prospective study statistical model weaning
Subjects: WB Practice of Medicine
WF Respiratory System
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib3 lib3
Date Deposited: 23 May 2020 05:39
Last Modified: 23 May 2020 05:39
URI: http://eprints.mums.ac.ir/id/eprint/16797

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