The Weaning Index combining EtCO2 and respiratory rate early identifies Spontaneous Breathing trial failure. A pilot study

TitreThe Weaning Index combining EtCO2 and respiratory rate early identifies Spontaneous Breathing trial failure. A pilot study
Type de publicationArticle de revue
AuteurBaudel, Jean-Luc, Dubée, Vincent , Boëlle, Pierre-Yves, Bourcier, Simon, Leblanc, Guillaume, Joffre, Jérémie, Bigé, Naïke, Preda, Gabriel, Dumas, Guillaume, Guidet, Bertrand, Maury, Eric, Ait-Oufella, Hafid
EditeurEdizioni Minerva Medica
TypeArticle scientifique dans une revue à comité de lecture
Année2019
LangueAnglais
DateAvril 2019
Numéro4
Pagination384-392
Volume85
Titre de la revueMinerva anestesiologica
ISSN1827-1596
Mots-clésEtCO2, Intensive care medicine, Mechanical ventilation, outcome, weaning
Résumé en anglais

BACKGROUND: We aimed to evaluate the predictive value of the end-tidal CO2 (EtCO2) alone or combined with ventilation related parameters on spontaneous breathing trial (SBT) outcome on mechanically ventilated patients.

METHODS: Prospective observational study in a medical ICU. Mechanically ventilated adult patients who met predefined criteria for weaning were included. Patients underwent a T-piece SBT for 30 minutes and the usual hemodynamic and respiratory clinical parameters including EtCO2 were recorded every 5 minutes.

RESULTS: 280 patients were studied (age: 64±17 years, SAPS II: 44 [34-56]) during a first SBT and 76 patients during a second SBT. The Weaning Index, defined as the product of the respiratory rate and EtCO2, was a strong early predictive factor of SBT outcome; at 10 minutes, the area under the curve (AUC) was 86% ([80-90], P<0.0001) during the first SBT and 88% ([80-96], P<0.0001) during the second SBT. After 10 minutes of SBT, a Weaning Index >1100 identified patients that will not successfully complete the SBT at 30 minutes with a specificity of 98%.

CONCLUSIONS: In unselected mechanically ventilated patients, the Weaning Index is helpful to early identify patients who will fail the SBT during a first and a second trial.

URL de la noticehttp://okina.univ-angers.fr/publications/ua18333
DOI10.23736/S0375-9393.18.13108-7
Lien vers le document

https://www.minervamedica.it/en/journals/minerva-anestesiologica/article...

Titre abrégéMinerva Anestesiol
Identifiant (ID) PubMed30482002