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Diagnostic value of an increase in central venous pressure during SBT for prediction of weaning failure in mechanically ventilated patients: A cross‐sectional study

BACKGROUND: Timely and successful extubation is an essential step forward in clinical practice to minimize complications of mechanical ventilation and unsuccessful weaning processes. Thus, research into predictive factors of weaning outcome to optimize spontaneous breathing trial (SBT) precision bef...

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Autores principales: Ghamari, Ali Akbar, Amini, Keivan, Daei Sorkhabi, Amin, Sarkesh, Aila, Saghaleini, Seyed Hadi, Asghari, Roghayeh, Rezayi, Mansour, Mahmoodpoor, Ata
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10102306/
https://www.ncbi.nlm.nih.gov/pubmed/37064307
http://dx.doi.org/10.1002/hsr2.1204
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author Ghamari, Ali Akbar
Amini, Keivan
Daei Sorkhabi, Amin
Sarkesh, Aila
Saghaleini, Seyed Hadi
Asghari, Roghayeh
Rezayi, Mansour
Mahmoodpoor, Ata
author_facet Ghamari, Ali Akbar
Amini, Keivan
Daei Sorkhabi, Amin
Sarkesh, Aila
Saghaleini, Seyed Hadi
Asghari, Roghayeh
Rezayi, Mansour
Mahmoodpoor, Ata
author_sort Ghamari, Ali Akbar
collection PubMed
description BACKGROUND: Timely and successful extubation is an essential step forward in clinical practice to minimize complications of mechanical ventilation and unsuccessful weaning processes. Thus, research into predictive factors of weaning outcome to optimize spontaneous breathing trial (SBT) precision before extubation is critical in intensive care practices. In this study, we aimed to investigate the predictive factors of the weaning outcome before and during SBT in mechanically ventilated patients. METHODS: In this cross‐sectional study, 159 mechanically ventilated patients who were eligible for SBT were enrolled. Of these patients, 140 had successful extubation, whereas the remainder failed. Each patient's PaCO(2) and PaO(2) levels, respiratory rate (RR), SpO(2), mean arterial pressure (MAP), heart rate (HR), and central venous pressure (CVP) values at the start of SBT, 3 min later, and at the end of SBT were measured. These values, along with the patients' clinical characteristics, were then investigated to determine if there was any correlation between these variables and the weaning outcome. RESULTS: Our analysis revealed that increase in CVP, independent of hemoglobin (Hb) concentration, PaO(2), SpO(2), duration of mechanical ventilation (MV), length of intensive care unit (ICU) stay, and SBT process, as well as underlying disease, was positively correlated with extubation/weaning failure. While age, gender, vital signs (MAP, RR, and HR), sequential organ failure assessment (SOFA), and acute physiology and chronic health evaluation (APACHE) scores had no significant correlation with patients' extubation outcomes. CONCLUSION: According to our findings, integrating CVP assessment into SBT besides routine indices measurement and monitoring can be considered for the prediction of weaning outcome in critically ill mechanically ventilated patients.
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spelling pubmed-101023062023-04-15 Diagnostic value of an increase in central venous pressure during SBT for prediction of weaning failure in mechanically ventilated patients: A cross‐sectional study Ghamari, Ali Akbar Amini, Keivan Daei Sorkhabi, Amin Sarkesh, Aila Saghaleini, Seyed Hadi Asghari, Roghayeh Rezayi, Mansour Mahmoodpoor, Ata Health Sci Rep Original Research BACKGROUND: Timely and successful extubation is an essential step forward in clinical practice to minimize complications of mechanical ventilation and unsuccessful weaning processes. Thus, research into predictive factors of weaning outcome to optimize spontaneous breathing trial (SBT) precision before extubation is critical in intensive care practices. In this study, we aimed to investigate the predictive factors of the weaning outcome before and during SBT in mechanically ventilated patients. METHODS: In this cross‐sectional study, 159 mechanically ventilated patients who were eligible for SBT were enrolled. Of these patients, 140 had successful extubation, whereas the remainder failed. Each patient's PaCO(2) and PaO(2) levels, respiratory rate (RR), SpO(2), mean arterial pressure (MAP), heart rate (HR), and central venous pressure (CVP) values at the start of SBT, 3 min later, and at the end of SBT were measured. These values, along with the patients' clinical characteristics, were then investigated to determine if there was any correlation between these variables and the weaning outcome. RESULTS: Our analysis revealed that increase in CVP, independent of hemoglobin (Hb) concentration, PaO(2), SpO(2), duration of mechanical ventilation (MV), length of intensive care unit (ICU) stay, and SBT process, as well as underlying disease, was positively correlated with extubation/weaning failure. While age, gender, vital signs (MAP, RR, and HR), sequential organ failure assessment (SOFA), and acute physiology and chronic health evaluation (APACHE) scores had no significant correlation with patients' extubation outcomes. CONCLUSION: According to our findings, integrating CVP assessment into SBT besides routine indices measurement and monitoring can be considered for the prediction of weaning outcome in critically ill mechanically ventilated patients. John Wiley and Sons Inc. 2023-04-13 /pmc/articles/PMC10102306/ /pubmed/37064307 http://dx.doi.org/10.1002/hsr2.1204 Text en © 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Ghamari, Ali Akbar
Amini, Keivan
Daei Sorkhabi, Amin
Sarkesh, Aila
Saghaleini, Seyed Hadi
Asghari, Roghayeh
Rezayi, Mansour
Mahmoodpoor, Ata
Diagnostic value of an increase in central venous pressure during SBT for prediction of weaning failure in mechanically ventilated patients: A cross‐sectional study
title Diagnostic value of an increase in central venous pressure during SBT for prediction of weaning failure in mechanically ventilated patients: A cross‐sectional study
title_full Diagnostic value of an increase in central venous pressure during SBT for prediction of weaning failure in mechanically ventilated patients: A cross‐sectional study
title_fullStr Diagnostic value of an increase in central venous pressure during SBT for prediction of weaning failure in mechanically ventilated patients: A cross‐sectional study
title_full_unstemmed Diagnostic value of an increase in central venous pressure during SBT for prediction of weaning failure in mechanically ventilated patients: A cross‐sectional study
title_short Diagnostic value of an increase in central venous pressure during SBT for prediction of weaning failure in mechanically ventilated patients: A cross‐sectional study
title_sort diagnostic value of an increase in central venous pressure during sbt for prediction of weaning failure in mechanically ventilated patients: a cross‐sectional study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10102306/
https://www.ncbi.nlm.nih.gov/pubmed/37064307
http://dx.doi.org/10.1002/hsr2.1204
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