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Ghiani, A; Walcher, S; Lutfi, A; Paderewska, J; Jaeger, SU; Kneidinger, N; Stecher, SS; Trudzinski, FC; Neurohr, C.
Mechanical power density, spontaneous breathing indexes, and prolonged weaning failure: a prospective cohort study.
Sci Rep. 2024; 14(1):16297 Doi: 10.1038/s41598-024-67237-w [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz
Kneidinger Nikolaus
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Abstract:
A prospective observational study comparing mechanical power density (MP normalized to dynamic compliance) with traditional spontaneous breathing indexes (e.g., predicted body weight normalized tidal volume [VT/PBW], rapid shallow breathing index [RSBI], or the integrative weaning index [IWI]) for predicting prolonged weaning failure in 140 tracheotomized patients. We assessed the diagnostic accuracy of these indexes at the start and end of the weaning procedure using ROC curve analysis, expressed as the area under the receiver operating characteristic curve (AUROC). Weaning failure occurred in 41 out of 140 patients (29%), demonstrating significantly higher MP density (6156 cmH2O2/min [4402-7910] vs. 3004 cmH2O2/min [2153-3917], P < 0.01), lower spontaneous VT/PBW (5.8 mL*kg-1 [4.8-6.8] vs. 6.6 mL*kg-1 [5.7-7.9], P < 0.01) higher RSBI (68 min-1*L-1 [44-91] vs. 55 min-1*L-1 [41-76], P < 0.01) and lower IWI (41 L2/cmH2O*%*min*10-3 [25-72] vs. 71 L2/cmH2O*%*min*10-3 [50-106], P < 0.01) and at the end of weaning. MP density was more accurate at predicting weaning failures (AUROC 0.91 [95%CI 0.84-0.95]) than VT/PBW (0.67 [0.58-0.74]), RSBI (0.62 [0.53-0.70]), or IWI (0.73 [0.65-0.80]), and may help clinicians in identifying patients at high risk for long-term ventilator dependency.
Find related publications in this database (using NLM MeSH Indexing)
Humans - administration & dosage
Ventilator Weaning - methods
Male - administration & dosage
Female - administration & dosage
Prospective Studies - administration & dosage
Aged - administration & dosage
Middle Aged - administration & dosage
Tidal Volume - physiology
Respiration - administration & dosage
ROC Curve - administration & dosage

Find related publications in this database (Keywords)
Mechanical ventilation
Prolonged weaning
Spontaneous breathing trial
Tracheostomy
Mechanical power
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