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Published in: Intensive Care Medicine 2/2004

01-02-2004 | Original

Extubation failure: diagnostic value of occlusion pressure (P0.1) and P0.1-derived parameters

Authors: Rafael Fernandez, Juan Maria Raurich, Teresa Mut, Jesus Blanco, Antonio Santos, Ana Villagra

Published in: Intensive Care Medicine | Issue 2/2004

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Abstract

Objective

To evaluate the ability of the new, built-in occlusion pressure (P0.1) measurement to predict extubation failure.

Design and setting

Prospective observational multicentre study in the ICU of five general hospitals.

Patients

Hundred thirty patients on mechanical ventilation longer than 48 h when considered ready for weaning.

Measurements and results

Patients underwent a 30-min spontaneous breathing trial with simultaneous monitoring of occlusion pressure (P0.1) and breathing pattern (f/Vt). Sixteen patients (12%) failed the weaning trial and full ventilatory support was resumed, while 114 tolerated the trial and were extubated. Twenty-one (18%) required reintubation within 48 h. The area under the ROC curve for diagnosing extubation failure was 0.53 for f/Vt, 0.59 for P0.1 and 0.61 for P0.1*f/Vt (p=NS). Accordingly, P0.1*f/Vt more than 100 detected extubation failure with a sensitivity of 0.89, specificity of 0.35, positive predictive value of 0.21 and negative predictive value of 0.94.

Conclusion

During a first trial of spontaneous breathing on pressure support ventilation (PSV), bedside P0.1 and P0.1*f/Vt are of little help, if any, for predicting extubation failure.
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Metadata
Title
Extubation failure: diagnostic value of occlusion pressure (P0.1) and P0.1-derived parameters
Authors
Rafael Fernandez
Juan Maria Raurich
Teresa Mut
Jesus Blanco
Antonio Santos
Ana Villagra
Publication date
01-02-2004
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 2/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-003-2070-y

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