The prediction of extubation success of postoperative neurosurgical patients using frequency-tidal volume ratios

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dc.contributor.authorVidotto, Milena Carlos [UNIFESP]
dc.contributor.authorSogame, Luciana Carrupt Machado
dc.contributor.authorCalciolari, Christiane Costa [UNIFESP]
dc.contributor.authorNascimento, Oliver Augusto [UNIFESP]
dc.contributor.authorJardim, José Roberto [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionEMESCAM
dc.date.accessioned2016-01-24T13:51:35Z
dc.date.available2016-01-24T13:51:35Z
dc.date.issued2008-08-01
dc.description.abstractBackground the process of discontinuing neurological patients from mechanical ventilation is still controversial. the aim of this study was to report the outcome from extubating patients undergoing elective craniotomy and correlate the result with the measured f/V(t) ratio.Materials and Methods in a cohort prospective study, all consecutive patients who required mechanical ventilation for up to 6 h after elective craniotomy were eligible for inclusion in this study. Patients passing daily screening criteria automatically received a spontaneous breathing trial (SBT). Immediately previous to the extubation, the expired minute volume (VE), breathing frequency (f), and tidal volume (V(t)) were measured and the breathing frequency-to-tidal volume ratio (f/V(t)) was calculated; consciousness level based on Glasgow Coma Scale (GCS) was evaluated at the same time. the extubation was considered a failure when patients needed reintubation within 48 h.Results Ninety-two patients were extubated and failure occurred in 16%. Despite 15 patients failed extubation just one of them presented the f/V(t) score over 105. the best cutoff value for f/V(t) observed was 62, but with low specificity (0.53) and negative predictive values (0.29). Area under the ROC curve for the f/V(t) was 0.69 +/- 0.07 (P = 0.02). Patients who failed the extubation process presented higher incidence of pneumonia (80%), higher need for tracheostomy (33%) and mortality rate of 40%.Conclusion the f/V(t) ratio does not predict extubation failure in patients who have undergone elective craniotomy. Patients who fail extubation present higher incidence of pneumonia, tracheostomy and higher mortality rate.en
dc.description.affiliationUniversidade Federal de São Paulo, Disciplina Pneumol Resp Div, BR-04023062 São Paulo, Brazil
dc.description.affiliationUnifesp, São Paulo, Brazil
dc.description.affiliationEMESCAM, Physiotherapy Course, Vitoria, ES, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Resp Physiotherapy Especializat Course, BR-04023062 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Disciplina Pneumol Resp Div, BR-04023062 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Resp Physiotherapy Especializat Course, BR-04023062 São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent83-89
dc.identifierhttps://dx.doi.org/10.1007/s12028-008-9059-x
dc.identifier.citationNeurocritical Care. Totowa: Humana Press Inc, v. 9, n. 1, p. 83-89, 2008.
dc.identifier.doi10.1007/s12028-008-9059-x
dc.identifier.issn1541-6933
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/30817
dc.identifier.wosWOS:000258657500012
dc.language.isoeng
dc.publisherHumana Press Inc
dc.relation.ispartofNeurocritical Care
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectVentilator weaningen
dc.subjectMechanical ventilationen
dc.subjectNeurosurgeryen
dc.subjectCraniotomyen
dc.subjectWeaning failureen
dc.subjectFrequency-tidal volu me ratioen
dc.titleThe prediction of extubation success of postoperative neurosurgical patients using frequency-tidal volume ratiosen
dc.typeinfo:eu-repo/semantics/article
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