scholarly journals Predictors of successful weaning in patients requiring extremely prolonged mechanical ventilation

2020 ◽  
Vol 88 (6) ◽  
pp. 477-484
Author(s):  
Yuval Leonov ◽  
Igor Kisil ◽  
Alona Perlov ◽  
Vladimir Stoichev ◽  
Yulia Ginzburg ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Prolonged Mechanical Ventilation ◽  
Successful Weaning

scholarly journals Predictors of successful weaning from prolonged mechanical ventilation in Taiwan

2009 ◽  
Vol 103 (8) ◽  
pp. 1189-1195 ◽  
Author(s):  
Yao-Kuang Wu ◽  
Kuo-Chin Kao ◽  
Kuang-Hung Hsu ◽  
Meng-Jer Hsieh ◽  
Ying-Huang Tsai
Keyword(s):  
Mechanical Ventilation ◽  
Prolonged Mechanical Ventilation ◽  
Successful Weaning

Can Creatinine Height Index Predict Weaning and Survival Outcomes in Patients on Prolonged Mechanical Ventilation After Critical Illness?

2016 ◽  
Vol 33 (2) ◽  
pp. 104-110 ◽  
Author(s):  
Debapriya Datta ◽  
Raymond Foley ◽  
Rong Wu ◽  
James Grady ◽  
Paul Scalise
Keyword(s):  
Mechanical Ventilation ◽  
Critical Illness ◽  
Total Protein ◽  
Prolonged Mechanical Ventilation ◽  
Strong Predictor ◽  
Multivariate Logistic Regression Analysis ◽  
Ideal Body Weight ◽  
Dichotomous Outcome ◽  
Successful Weaning ◽  
The Impact

Objective: Malnutrition is common in chronic critically ill patients on prolonged mechanical ventilation (PMV) and may affect weaning. The creatinine height index (CHI), which reflects lean muscle mass, is regarded as the most accurate indicator of malnutrition. The objective of this study was to determine the impact of CHI in comparison with other traditional nutritional indices on successful weaning and survival in patients on PMV after critical illness. Methods: Records of 167 patients on PMV following critical illness, admitted for weaning, were reviewed. Parameters studied included age, gender, body mass index (BMI), percentage ideal body weight (%IBW), total protein, albumin, prealbumin, hemoglobin (Hb), and cause of respiratory failure. Number successfully weaned and number discharged alive and time to wean and time to discharge alive were determined from records. The CHI was calculated from 24-hour urine creatinine using a standard formula. Unpaired 2-sample t test was performed to determine the association between the studied nutritional parameters and outcomes. Predictive value of studied parameters for successful weaning and survival was determined by multivariate logistic regression analysis to model dichotomous outcome of successful weaning and survival. Results: Mean age was 68 ± 14 years, 49% were males, 64% were successfully weaned, and 65.8% survived. Total protein, Hb, and CHI had a significant impact on successful weaning. Weight, %IBW, BMI, and CHI had a significant effect on survival. Of all parameters, CHI was most strongly predictive of successful weaning and survival. Conclusions: The CHI is a strong predictor of successful weaning and survival in patients on PMV.

Successful weaning from prolonged mechanical ventilation by embolization of aorta-pulmonary collateral arteries

1990 ◽  
Vol 4 (3) ◽  
pp. 282-284
Author(s):  
Hiromasa Inoue ◽  
Takeyoshi Sata ◽  
Akinori Zaitsu ◽  
Hiroyuki Kohno ◽  
Shozo Tamura ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Prolonged Mechanical Ventilation ◽  
Collateral Arteries ◽  
Successful Weaning

scholarly journals Hypercapnic Ventilatory Response in the Weaning of Patients with Prolonged Mechanical Ventilation

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Chung-Shu Lee ◽  
Ning-Hung Chen ◽  
Li-Pang Chuang ◽  
Chih-Hao Chang ◽  
Li-Fu Li ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Ventilatory Response ◽  
Prolonged Mechanical Ventilation ◽  
Ventilatory Responses ◽  
Hypercapnic Ventilatory Response ◽  
Weaning Failure ◽  
Successful Weaning ◽  
Receiver Operating

Objective. To investigate whether hypercapnic ventilatory response (defined as the ratio of the change in minute ventilation [ΔV˙E] to the change in end-tidal partial pressure of carbon dioxide [ΔPETCO2]) is a predictor of successful weaning in patients with prolonged mechanical ventilation (PMV) and to determine a reference value for clinical use.Methods. A hypercapnic challenge test was performed on 32 PMV subjects (average age: 74.3 years ± 14.9 years). The subjects were divided into two groups (i.e., weaning successes and weaning failures) and their hypercapnic ventilatory responses were compared.Results. PMV subjects had an overall weaning rate of 68.8%. The weaning-success and weaning-failure groups had hypercapnic ventilatory responses (ΔV˙E/ΔPETCO2) of0.40±0.16and0.28±0.12 L/min/mmHg, respectively (P=.036). The area under the receiver operating characteristic curve was 0.716 of the hypercapnic ventilatory response, and the practical hypercapnic ventilatory response cut-off point for successful weaning was 0.265 with 86.4% sensitivity and 50% specificity.Conclusions. PMV subjects who failed weaning had a lower hypercapnic ventilatory response than successfully weaned subjects. However, the prediction capacity of this test, assessed by the area under the receiver operating characteristic (ROC) curve, poorly predicted weaning outcome.

WHEN DOES A RELAPSE OCCUR FOLLOWING SUCCESSFUL WEANING FROM PROLONGED MECHANICAL VENTILATION?

CHEST Journal ◽  
2008 ◽  
Vol 134 (4) ◽  
pp. 164P
Author(s):  
J Dermot Frengley ◽  
Giorgio R. Sansone ◽  
Yan Man ◽  
John J. Vecchione ◽  
Chaudry Ghumman ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Prolonged Mechanical Ventilation ◽  
Successful Weaning

scholarly journals Reinstitution of Mechanical Ventilation within 14 Days as a Poor Predictor in Prolonged Mechanical Ventilation Patients following Successful Weaning

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Mei-Lien Tu ◽  
Ching-Wan Tseng ◽  
Yuh Chyn Tsai ◽  
Chin-Chou Wang ◽  
Chia-Cheng Tseng ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Proportional Hazards ◽  
Prolonged Mechanical Ventilation ◽  
Care Center ◽  
Group Versus ◽  
Cox Proportional Hazards ◽  
Poor Predictor ◽  
Significant Difference ◽  
Successful Weaning ◽  
One Year

Although many parameters were investigated about weaning and mortality in critical patients in intensive units, no studies have yet investigated predictors in prolonged mechanical ventilation (PMV) patients following successful weaning. A cohort of 142 consecutive PMV patients with successful weaning in our respiratory care center was enrolled in this study. Successful weaning is defined as a patient having smooth respiration for more than 5 days after weaning. The results showed as follows: twenty-seven patients (19%) had the reinstitution within 14 days, and 115 patients (81%) had the reinstitution beyond 14 days. Renal disease RIFLE-LE was associated with the reinstitution within 14 days (P=0.006). One year mortality rates showed significant difference between the two groups (85.2% in the reinstitution within 14 days group versus 53.1% in the reinstitution beyond 14 days;P<0.001). Kaplan-Meier analysis showed that age ≥70 years (P=0.04), ESRD (P=0.02), and the reinstitution within 14 days (P<0.001) were associated with one-year mortality. Cox proportional hazards regression model showed that only the reinstitution within 14 days was the independent predictor for mortality (P<0.001). In conclusion, the reinstitution within 14 days was a poor predictor for PMV patients after successful weaning.

scholarly journals APACHE II score cannot predict successful weaning from prolonged mechanical ventilation

2017 ◽  
Vol 14 (3) ◽  
pp. 270-275 ◽  
Author(s):  
Anna Rojek-Jarmuła ◽  
Rainer Hombach ◽  
Łukasz J Krzych
Keyword(s):  
Mechanical Ventilation ◽  
Prolonged Mechanical Ventilation ◽  
Characteristic Curve ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Tube Removal ◽  
Successful Weaning ◽  
Respiratory Weaning ◽  
Weaning Outcome ◽  
Admission Glasgow Coma Scale

At least 5% of all intensive care unit patients require prolonged respiratory support. Multiple factors have been suggested as possible predictors of successful respiratory weaning so far. We sought to verify whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) can predict freedom from prolonged mechanical ventilation (PMV) in patients treated in a regional weaning centre. The study group comprised 130 consecutive patients (age; median (interquartile range): 71 (62–77) years), hospitalized between 1 January 2012, and 31 December 2013. APACHE II score was assessed based on the worst values taken during the first 24 hours after admission. Glasgow coma scale was excluded from calculations due to the likely influence of sedative agents. The outcome was defined as freedom from mechanical ventilation, with or without tracheostomy on discharge. Among survivors ( n = 115), 88.2% were successfully liberated from mechanical ventilation and 60.9% from tracheostomy. APACHE II failed to predict freedom from mechanical ventilation (area under the receiver–operating characteristic curve [AUROC] = 0.534; 95% confidence interval [CI]: 0.439–0.628; p = 0.65) and tracheostomy tube removal (AUROC = 0.527; 95% CI: 0.431–0.621; p = 0.63). Weaning outcome was unrelated to the aetiology of respiratory failure on admission ( p = 0.41). APACHE II cannot predict weaning outcome in patients requiring PMV.

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