Linfu Bai1, Jun Duan2. 1. Department of Respiratory Medicine, First Affiliated Hospital of Chongqing Medical University, Chongqing, China. 2. Department of Respiratory Medicine, First Affiliated Hospital of Chongqing Medical University, Chongqing, China. duanjun412589@163.com.
Abstract
BACKGROUND: A ventilator includes the function to measure flow velocity. We aimed to compare the predictive accuracy for re-intubation diagnosed by cough peak flow (CPF) measured by a spirometer and a ventilator. METHODS: Endotracheally intubated subjects who passed a spontaneous breathing trial were enrolled. Before extubation, CPF was measured by a spirometer and a ventilator, respectively. Re-intubation was recorded at 72 h after extubation. RESULTS: A total of 126 subjects were enrolled. Among them, 15 subjects (12%) experienced re-intubation. CPF was lower in re-intubated subjects than those without re-intubation (measured by a spirometer: 54 ± 30 L/min vs 86 ± 37 L/min, P < .001; and measured by a ventilator: 50 ± 22 L/min vs 80 ± 26 L/min, P < .001). CPF measured by a spirometer and a ventilator had similar area under the curve of receiver operating characteristic (0.79 vs 0.83, P = .26). When a CPF of 56.4 L/min was measured by a spirometer as cutoff value, the sensitivity and specificity to distinguish re-intubation was 73 and 87%, respectively. When it was measured by a ventilator, the cutoff value, sensitivity, and specificity were 56 L/min, 73%, and 85%, respectively. CONCLUSIONS: CPF measurement by a ventilator was convenient, affordable, and safe. It had a predictive accuracy for re-intubation similar to that of a spirometer.
BACKGROUND: A ventilator includes the function to measure flow velocity. We aimed to compare the predictive accuracy for re-intubation diagnosed by cough peak flow (CPF) measured by a spirometer and a ventilator. METHODS: Endotracheally intubated subjects who passed a spontaneous breathing trial were enrolled. Before extubation, CPF was measured by a spirometer and a ventilator, respectively. Re-intubation was recorded at 72 h after extubation. RESULTS: A total of 126 subjects were enrolled. Among them, 15 subjects (12%) experienced re-intubation. CPF was lower in re-intubated subjects than those without re-intubation (measured by a spirometer: 54 ± 30 L/min vs 86 ± 37 L/min, P < .001; and measured by a ventilator: 50 ± 22 L/min vs 80 ± 26 L/min, P < .001). CPF measured by a spirometer and a ventilator had similar area under the curve of receiver operating characteristic (0.79 vs 0.83, P = .26). When a CPF of 56.4 L/min was measured by a spirometer as cutoff value, the sensitivity and specificity to distinguish re-intubation was 73 and 87%, respectively. When it was measured by a ventilator, the cutoff value, sensitivity, and specificity were 56 L/min, 73%, and 85%, respectively. CONCLUSIONS: CPF measurement by a ventilator was convenient, affordable, and safe. It had a predictive accuracy for re-intubation similar to that of a spirometer.
Authors: Lorcan McGarvey; Bruce K Rubin; Satoru Ebihara; Karen Hegland; Alycia Rivet; Richard S Irwin; Donald C Bolser; Anne B Chang; Peter G Gibson; Stuart B Mazzone Journal: Chest Date: 2021-04-24 Impact factor: 10.262