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Sustained maximal inspiratory manoeuvres can be used to predict extubation outcome after prolonged periods of mechanical ventilation

Sustained maximal inspiratory manoeuvres can be used to predict extubation outcome after prolonged periods of mechanical ventilation
Sustained maximal inspiratory manoeuvres can be used to predict extubation outcome after prolonged periods of mechanical ventilation
Rationale: Maximal inspiratory pressure (MIP) is an accepted effort-dependent measure of global inspiratory muscle strength. Although numerous studies have examined its ability to predict weaning /extubation outcome after mechanical ventilation, MIP has generally been found to have lower specificity than is clinically acceptable. The Respiratory Trainer (RT2) is a new device originally conceived as a methodology for training the inspiratory muscles. It generates three measures of inspiratory muscle function including a new measure called prolonged MIP (PMIP) area. This is calculated as the area under the curve produced by sampling maximal inspiratory pressure at 16 Hz during a sustained inspiratory manoeuvre.
Methods: Twenty-seven intubated adults who had required prolonged mechanical ventilation (48 hours plus) and were deemed ready for extubation were measured using the RT2 prior to extubation. Differences in PMIP area measures between extubation success and failure outcome groups were then sought using independent samples t tests. Sensitivity and specificity of different levels of PMIP area to predict outcome were also calculated using ROC curves.
Results: Significant differences in PMIP area were found between the extubation success and failure groups (t = 7.371, p <0.001). A PMIP area cut-off point of 57.5 pressure-time units gave a sensitivity and specificity of 1.0 for extubation outcome prediction.
Conclusion: PMIP area measures were significantly different in the extubation success and failure outcome groups. This work suggests that PMIP area may have a role in predicting extubation outcome after prolonged periods of mechanical ventilation.
outcome, care
1073-449X
A890
Bruton, A.
a8cc274a-64af-4884-b76b-618ef6c29dad
Conway, J.H.
31968645-34bf-49e2-906d-b3e3487f13e5
Holgate, S.T.
48e197d1-3681-43c1-9a3e-478311f6618d
Bruton, A.
a8cc274a-64af-4884-b76b-618ef6c29dad
Conway, J.H.
31968645-34bf-49e2-906d-b3e3487f13e5
Holgate, S.T.
48e197d1-3681-43c1-9a3e-478311f6618d

Bruton, A., Conway, J.H. and Holgate, S.T. (2001) Sustained maximal inspiratory manoeuvres can be used to predict extubation outcome after prolonged periods of mechanical ventilation. American Journal of Respiratory and Critical Care Medicine, 163 (Supplement), A890.

Record type: Article

Abstract

Rationale: Maximal inspiratory pressure (MIP) is an accepted effort-dependent measure of global inspiratory muscle strength. Although numerous studies have examined its ability to predict weaning /extubation outcome after mechanical ventilation, MIP has generally been found to have lower specificity than is clinically acceptable. The Respiratory Trainer (RT2) is a new device originally conceived as a methodology for training the inspiratory muscles. It generates three measures of inspiratory muscle function including a new measure called prolonged MIP (PMIP) area. This is calculated as the area under the curve produced by sampling maximal inspiratory pressure at 16 Hz during a sustained inspiratory manoeuvre.
Methods: Twenty-seven intubated adults who had required prolonged mechanical ventilation (48 hours plus) and were deemed ready for extubation were measured using the RT2 prior to extubation. Differences in PMIP area measures between extubation success and failure outcome groups were then sought using independent samples t tests. Sensitivity and specificity of different levels of PMIP area to predict outcome were also calculated using ROC curves.
Results: Significant differences in PMIP area were found between the extubation success and failure groups (t = 7.371, p <0.001). A PMIP area cut-off point of 57.5 pressure-time units gave a sensitivity and specificity of 1.0 for extubation outcome prediction.
Conclusion: PMIP area measures were significantly different in the extubation success and failure outcome groups. This work suggests that PMIP area may have a role in predicting extubation outcome after prolonged periods of mechanical ventilation.

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More information

Published date: 2001
Additional Information: Poster presentation D40, F18 at 2001 Meeting of the American Thoracic Society, San Francisco, USA, 18-23 May 2001
Keywords: outcome, care

Identifiers

Local EPrints ID: 17836
URI: https://eprints.soton.ac.uk/id/eprint/17836
ISSN: 1073-449X
PURE UUID: a8610fbd-de8b-4c50-911f-029bab7ed9ad

Catalogue record

Date deposited: 30 May 2006
Last modified: 17 Jul 2017 16:37

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Contributors

Author: A. Bruton
Author: J.H. Conway
Author: S.T. Holgate

University divisions

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