Leonardo Cordeiro de Souza1, Fernando Silva Guimarães2, Jocemir Ronaldo Lugon3. 1. Medical Science Post-graduation Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil leonardo.uti@gmail.com. 2. Physiotherapy School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. 3. Nephrology Division, Department of Medicine, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
Abstract
PURPOSE: The performance of most indices used to predict ventilator weaning outcomes remains below expectation. The purpose of this study was to evaluate a new weaning index, the timed inspiratory effort (TIE) index, which is based on the maximal inspiratory pressure and the occlusion time required to reach it. METHODS: This observational prospective study included patients undergoing mechanical ventilation. Patients ready to be weaned had their TIE index and 6 previously reported indices recorded. The primary end point was the overall predictive performance of the studied weaning indices (area under the receiver operating characteristic curves [AUCs]). The secondary end points were sensitivity, specificity, positive predictive value, and negative predictive value. P values <.05 were considered significant. RESULTS: From the 128 initially screened patients, the 103 patients selected for the study included 45 women and 58 men (mean age 60.8 ± 19.8 years). In all, 60 patients were weaned, 43 were not weaned, and 32 died during the study period. Tracheotomy was necessary in 61 patients. The mean duration of mechanical ventilation was 17.5 ± 17.3 days. The AUC of 3 weaning predictors (the TIE index, the integrative weaning index, and the frequency-to-tidal volume [f/Vt] ratio index) was higher than the other indices. The TIE index had the largest AUC. CONCLUSION: The TIE index performed better than the best weaning indices used in clinical practice.
PURPOSE: The performance of most indices used to predict ventilator weaning outcomes remains below expectation. The purpose of this study was to evaluate a new weaning index, the timed inspiratory effort (TIE) index, which is based on the maximal inspiratory pressure and the occlusion time required to reach it. METHODS: This observational prospective study included patients undergoing mechanical ventilation. Patients ready to be weaned had their TIE index and 6 previously reported indices recorded. The primary end point was the overall predictive performance of the studied weaning indices (area under the receiver operating characteristic curves [AUCs]). The secondary end points were sensitivity, specificity, positive predictive value, and negative predictive value. P values <.05 were considered significant. RESULTS: From the 128 initially screened patients, the 103 patients selected for the study included 45 women and 58 men (mean age 60.8 ± 19.8 years). In all, 60 patients were weaned, 43 were not weaned, and 32 died during the study period. Tracheotomy was necessary in 61 patients. The mean duration of mechanical ventilation was 17.5 ± 17.3 days. The AUC of 3 weaning predictors (the TIE index, the integrative weaning index, and the frequency-to-tidal volume [f/Vt] ratio index) was higher than the other indices. The TIE index had the largest AUC. CONCLUSION: The TIE index performed better than the best weaning indices used in clinical practice.
Authors: Reza Goharani; Amir Vahedian-Azimi; Iman H Galal; Leonardo Cordeiro de Souza; Behrooz Farzanegan; Farshid R Bashar; Michele Vitacca; Seyedpouzhia Shojaei; Seyed M M Mosavinasab; Shunsuke Takaki; Andrew C Miller Journal: J Thorac Dis Date: 2019-04 Impact factor: 2.895
Authors: Leonardo Cordeiro de Souza; Josué Felipe Campos; Leandro Possidente Daher; Priscila Furtado da Silva; Alex Ventura; Pollyana Zamborlini do Prado; Daniele Brasil; Debora Mendonça; Jocemir Ronaldo Lugon Journal: Case Rep Crit Care Date: 2014-07-24
Authors: Leonardo Cordeiro de Souza; Amarildo Abreu de Souza; Eric Eduardo Pinto de Almeida; Leo Honse Ribeiro; Marcos David Parada Godoy; Wanderlei Augusto Junior; Jocemir Ronaldo Lugon Journal: Case Rep Crit Care Date: 2018-10-04