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Maximal expiratory pressure compared with maximal expiratory pressure during induced cough as a predictor of extubation failure
OBJECTIVE: To compare the diagnostic performance of maximal expiratory pressure with maximal expiratory pressure during induced cough for predicting extubation failure within 72 hours in patients who completed a spontaneous breathing trial (SBT). METHODS: The study was conducted between October 2018...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Associação de Medicina Intensiva Brasileira - AMIB
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10275301/ https://www.ncbi.nlm.nih.gov/pubmed/37712728 http://dx.doi.org/10.5935/2965-2774.20230275-en |
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author | Carrera, Melina Urrutia, Jose García Ardariz, Cesar Bueno Porra, Maria Luz Gamarra, Claudio Ballve, Ladislao Pablo Diaz |
author_facet | Carrera, Melina Urrutia, Jose García Ardariz, Cesar Bueno Porra, Maria Luz Gamarra, Claudio Ballve, Ladislao Pablo Diaz |
author_sort | Carrera, Melina |
collection | PubMed |
description | OBJECTIVE: To compare the diagnostic performance of maximal expiratory pressure with maximal expiratory pressure during induced cough for predicting extubation failure within 72 hours in patients who completed a spontaneous breathing trial (SBT). METHODS: The study was conducted between October 2018 and September 2019. All patients aged over 18 years admitted to the intensive care unit who required invasive mechanical ventilation for over 48 hours and successfully completed a spontaneous breathing trial were included. The maximal expiratory pressure was assessed with a unidirectional valve for 40 seconds, and verbal encouragement was given. The maximal expiratory pressure during induced cough was measured with slow instillation of 2mL of a 0.9% saline solution. The primary outcome variable was extubation failure. RESULTS: Eighty patients were included, of which 43 (54%) were male. Twenty-two patients [27.5% (95%CI 18.9 - 38.1)] failed extubation within 72 hours. Differences were observed in the maximal expiratory pressure during induced cough between the group who failed extubation, with a median of 0cmH(2)O (P(25-75): 0 - 90), and the group without extubation failure, with a median of 120cmH(2)O (P(25-75): 73 - 120); p < 0.001. CONCLUSION: In patients who completed a spontaneous breathing trial, the maximal expiratory pressure during induced cough had a higher diagnostic performance for predicting extubation failure within 72 hours. Clinicaltrials.gov Registry: NCT04356625 |
format | Online Article Text |
id | pubmed-10275301 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Associação de Medicina Intensiva Brasileira - AMIB |
record_format | MEDLINE/PubMed |
spelling | pubmed-102753012023-06-17 Maximal expiratory pressure compared with maximal expiratory pressure during induced cough as a predictor of extubation failure Carrera, Melina Urrutia, Jose García Ardariz, Cesar Bueno Porra, Maria Luz Gamarra, Claudio Ballve, Ladislao Pablo Diaz Crit Care Sci Original Article OBJECTIVE: To compare the diagnostic performance of maximal expiratory pressure with maximal expiratory pressure during induced cough for predicting extubation failure within 72 hours in patients who completed a spontaneous breathing trial (SBT). METHODS: The study was conducted between October 2018 and September 2019. All patients aged over 18 years admitted to the intensive care unit who required invasive mechanical ventilation for over 48 hours and successfully completed a spontaneous breathing trial were included. The maximal expiratory pressure was assessed with a unidirectional valve for 40 seconds, and verbal encouragement was given. The maximal expiratory pressure during induced cough was measured with slow instillation of 2mL of a 0.9% saline solution. The primary outcome variable was extubation failure. RESULTS: Eighty patients were included, of which 43 (54%) were male. Twenty-two patients [27.5% (95%CI 18.9 - 38.1)] failed extubation within 72 hours. Differences were observed in the maximal expiratory pressure during induced cough between the group who failed extubation, with a median of 0cmH(2)O (P(25-75): 0 - 90), and the group without extubation failure, with a median of 120cmH(2)O (P(25-75): 73 - 120); p < 0.001. CONCLUSION: In patients who completed a spontaneous breathing trial, the maximal expiratory pressure during induced cough had a higher diagnostic performance for predicting extubation failure within 72 hours. Clinicaltrials.gov Registry: NCT04356625 Associação de Medicina Intensiva Brasileira - AMIB 2023 /pmc/articles/PMC10275301/ /pubmed/37712728 http://dx.doi.org/10.5935/2965-2774.20230275-en Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Carrera, Melina Urrutia, Jose García Ardariz, Cesar Bueno Porra, Maria Luz Gamarra, Claudio Ballve, Ladislao Pablo Diaz Maximal expiratory pressure compared with maximal expiratory pressure during induced cough as a predictor of extubation failure |
title | Maximal expiratory pressure compared with maximal expiratory pressure
during induced cough as a predictor of extubation failure |
title_full | Maximal expiratory pressure compared with maximal expiratory pressure
during induced cough as a predictor of extubation failure |
title_fullStr | Maximal expiratory pressure compared with maximal expiratory pressure
during induced cough as a predictor of extubation failure |
title_full_unstemmed | Maximal expiratory pressure compared with maximal expiratory pressure
during induced cough as a predictor of extubation failure |
title_short | Maximal expiratory pressure compared with maximal expiratory pressure
during induced cough as a predictor of extubation failure |
title_sort | maximal expiratory pressure compared with maximal expiratory pressure
during induced cough as a predictor of extubation failure |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10275301/ https://www.ncbi.nlm.nih.gov/pubmed/37712728 http://dx.doi.org/10.5935/2965-2774.20230275-en |
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