The new prognostic factor in pre-intubation follow-up of critically ill patients: integrated pulmonary index monitoring

OBJECTIVE: The objective of this study was to identify the integrated pulmonary index in the follow-up of non-intubated critically ill patients in the emergency department and its efficacy in deciding on advanced airway application in comparison with the Glasgow Coma Scale. METHODS: This is a prospective, single-center, methodological study. In our study, we recorded the demographic characteristics, Glasgow Coma Scale, and the integrated pulmonary index of 90 patients with respiratory failure who were followed up in the emergency department between June 1, 2019 and September 1, 2019, and we compared the results of Glasgow Coma Scale and integrated pulmonary index in making the endotracheal intubation decision. RESULTS: Endotracheal intubation was applied to 30% of the 90 patients included in the study. The area under the curve was calculated as 0.906 for integrated pulmonary index and 0.860 for Glasgow Coma Scale in predicting endotracheal intubation. There was no significant difference between the area under the curves of integrated pulmonary index and Glasgow Coma Scale. According to the best cutoff values determined in the estimation of endotracheal intubation, sensitivity was 74.07% and specificity was 95.24% for integrated pulmonary index, and sensitivity was 74.07% and specificity was 85.71% for Glasgow Coma Scale. CONCLUSION: The integrated pulmonary index monitoring provides an objective evaluation in the follow-up of critically ill patients with spontaneous breathing in the emergency department and is predictive in deciding on timely endotracheal intubation.