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Prediction of extubation failure in medical intensive care unit patients

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Prediction of extubation failure in medical intensive care unit patients. / Saugel, Bernd; Rakette, Philipp; Hapfelmeier, Alexander; Schultheiss, Caroline; Phillip, Veit; Thies, Philipp; Treiber, Matthias; Einwächter, Henrik; von Werder, Alexander; Pfab, Rudi; Eyer, Florian; Schmid, Roland M; Huber, Wolfgang.

In: J CRIT CARE, Vol. 27, No. 6, 01.12.2012, p. 571-7.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Saugel, B, Rakette, P, Hapfelmeier, A, Schultheiss, C, Phillip, V, Thies, P, Treiber, M, Einwächter, H, von Werder, A, Pfab, R, Eyer, F, Schmid, RM & Huber, W 2012, 'Prediction of extubation failure in medical intensive care unit patients', J CRIT CARE, vol. 27, no. 6, pp. 571-7. https://doi.org/10.1016/j.jcrc.2012.01.010

APA

Saugel, B., Rakette, P., Hapfelmeier, A., Schultheiss, C., Phillip, V., Thies, P., Treiber, M., Einwächter, H., von Werder, A., Pfab, R., Eyer, F., Schmid, R. M., & Huber, W. (2012). Prediction of extubation failure in medical intensive care unit patients. J CRIT CARE, 27(6), 571-7. https://doi.org/10.1016/j.jcrc.2012.01.010

Vancouver

Saugel B, Rakette P, Hapfelmeier A, Schultheiss C, Phillip V, Thies P et al. Prediction of extubation failure in medical intensive care unit patients. J CRIT CARE. 2012 Dec 1;27(6):571-7. https://doi.org/10.1016/j.jcrc.2012.01.010

Bibtex

@article{c979c6ae3cb346b7827b6e765503dc87,
title = "Prediction of extubation failure in medical intensive care unit patients",
abstract = "PURPOSE: The purpose of this study was to evaluate prediction factors for extubation failure (need for reintubation within 48 hours) in medical intensive care unit patients.MATERIALS AND METHODS: Sixty-one patients extubated after mechanical ventilation for more than 48 hours were included in the study. A retrospective analysis of medical records and a prospectively maintained database on respiratory parameters was conducted.RESULTS: Low serum anion gap (P = .001), low serum anion gap corrected for serum albumin (P = .010), and low arterial partial pressure of oxygen (Pao(2))/fraction of inspired oxygen (Fio(2)) ratio (P = .032) were significantly associated with extubation failure. Binary logistic regression analysis revealed low uncorrected and corrected serum anion gap (P = .006 and P = .025, respectively; odds ratio, 0.59 for both) and low Pao(2)/Fio(2) ratio (P = .038; odds ratio, 0.99) as risk factors for extubation failure. Regarding extubation failure, receiver operating characteristic curve (ROC) analysis demonstrated good predictive capabilities of serum anion gap (ROC area under the curve, 0.835; P = .004; cutoff, 7.7 mEq/L; sensitivity, 70.4%; specificity, 85.7%) and corrected serum anion gap (ROC area under the curve, 0.808; P = .009; cutoff, 8.8 mEq/L; sensitivity, 87.5%; specificity, 71.4%). A significantly higher risk for extubation failure was observed in patients with serum anion gap 5.2 mEq/L or less (relative risk, 8.8; 95% confidence interval, 2.4-32.4; P = .004) and corrected serum anion gap 8.6 mEq/L or less (relative risk, 10.0; 95% confidence interval, 2.2-44.9; P = .004).CONCLUSIONS: Low preextubation serum anion gap values and low preextubation Pao(2)/Fio(2) ratio might help to predict extubation failure in medical intensive care unit patients.",
keywords = "Acid-Base Equilibrium, Aged, Airway Extubation, Blood Gas Analysis, Female, Humans, Intensive Care Units, Male, Middle Aged, ROC Curve, Retrospective Studies, Serum Albumin, Ventilator Weaning",
author = "Bernd Saugel and Philipp Rakette and Alexander Hapfelmeier and Caroline Schultheiss and Veit Phillip and Philipp Thies and Matthias Treiber and Henrik Einw{\"a}chter and {von Werder}, Alexander and Rudi Pfab and Florian Eyer and Schmid, {Roland M} and Wolfgang Huber",
note = "Copyright {\textcopyright} 2012 Elsevier Inc. All rights reserved.",
year = "2012",
month = dec,
day = "1",
doi = "10.1016/j.jcrc.2012.01.010",
language = "English",
volume = "27",
pages = "571--7",
journal = "J CRIT CARE",
issn = "0883-9441",
publisher = "Elsevier BV",
number = "6",

}

RIS

TY - JOUR

T1 - Prediction of extubation failure in medical intensive care unit patients

AU - Saugel, Bernd

AU - Rakette, Philipp

AU - Hapfelmeier, Alexander

AU - Schultheiss, Caroline

AU - Phillip, Veit

AU - Thies, Philipp

AU - Treiber, Matthias

AU - Einwächter, Henrik

AU - von Werder, Alexander

AU - Pfab, Rudi

AU - Eyer, Florian

AU - Schmid, Roland M

AU - Huber, Wolfgang

N1 - Copyright © 2012 Elsevier Inc. All rights reserved.

PY - 2012/12/1

Y1 - 2012/12/1

N2 - PURPOSE: The purpose of this study was to evaluate prediction factors for extubation failure (need for reintubation within 48 hours) in medical intensive care unit patients.MATERIALS AND METHODS: Sixty-one patients extubated after mechanical ventilation for more than 48 hours were included in the study. A retrospective analysis of medical records and a prospectively maintained database on respiratory parameters was conducted.RESULTS: Low serum anion gap (P = .001), low serum anion gap corrected for serum albumin (P = .010), and low arterial partial pressure of oxygen (Pao(2))/fraction of inspired oxygen (Fio(2)) ratio (P = .032) were significantly associated with extubation failure. Binary logistic regression analysis revealed low uncorrected and corrected serum anion gap (P = .006 and P = .025, respectively; odds ratio, 0.59 for both) and low Pao(2)/Fio(2) ratio (P = .038; odds ratio, 0.99) as risk factors for extubation failure. Regarding extubation failure, receiver operating characteristic curve (ROC) analysis demonstrated good predictive capabilities of serum anion gap (ROC area under the curve, 0.835; P = .004; cutoff, 7.7 mEq/L; sensitivity, 70.4%; specificity, 85.7%) and corrected serum anion gap (ROC area under the curve, 0.808; P = .009; cutoff, 8.8 mEq/L; sensitivity, 87.5%; specificity, 71.4%). A significantly higher risk for extubation failure was observed in patients with serum anion gap 5.2 mEq/L or less (relative risk, 8.8; 95% confidence interval, 2.4-32.4; P = .004) and corrected serum anion gap 8.6 mEq/L or less (relative risk, 10.0; 95% confidence interval, 2.2-44.9; P = .004).CONCLUSIONS: Low preextubation serum anion gap values and low preextubation Pao(2)/Fio(2) ratio might help to predict extubation failure in medical intensive care unit patients.

AB - PURPOSE: The purpose of this study was to evaluate prediction factors for extubation failure (need for reintubation within 48 hours) in medical intensive care unit patients.MATERIALS AND METHODS: Sixty-one patients extubated after mechanical ventilation for more than 48 hours were included in the study. A retrospective analysis of medical records and a prospectively maintained database on respiratory parameters was conducted.RESULTS: Low serum anion gap (P = .001), low serum anion gap corrected for serum albumin (P = .010), and low arterial partial pressure of oxygen (Pao(2))/fraction of inspired oxygen (Fio(2)) ratio (P = .032) were significantly associated with extubation failure. Binary logistic regression analysis revealed low uncorrected and corrected serum anion gap (P = .006 and P = .025, respectively; odds ratio, 0.59 for both) and low Pao(2)/Fio(2) ratio (P = .038; odds ratio, 0.99) as risk factors for extubation failure. Regarding extubation failure, receiver operating characteristic curve (ROC) analysis demonstrated good predictive capabilities of serum anion gap (ROC area under the curve, 0.835; P = .004; cutoff, 7.7 mEq/L; sensitivity, 70.4%; specificity, 85.7%) and corrected serum anion gap (ROC area under the curve, 0.808; P = .009; cutoff, 8.8 mEq/L; sensitivity, 87.5%; specificity, 71.4%). A significantly higher risk for extubation failure was observed in patients with serum anion gap 5.2 mEq/L or less (relative risk, 8.8; 95% confidence interval, 2.4-32.4; P = .004) and corrected serum anion gap 8.6 mEq/L or less (relative risk, 10.0; 95% confidence interval, 2.2-44.9; P = .004).CONCLUSIONS: Low preextubation serum anion gap values and low preextubation Pao(2)/Fio(2) ratio might help to predict extubation failure in medical intensive care unit patients.

KW - Acid-Base Equilibrium

KW - Aged

KW - Airway Extubation

KW - Blood Gas Analysis

KW - Female

KW - Humans

KW - Intensive Care Units

KW - Male

KW - Middle Aged

KW - ROC Curve

KW - Retrospective Studies

KW - Serum Albumin

KW - Ventilator Weaning

U2 - 10.1016/j.jcrc.2012.01.010

DO - 10.1016/j.jcrc.2012.01.010

M3 - SCORING: Journal article

C2 - 22440323

VL - 27

SP - 571

EP - 577

JO - J CRIT CARE

JF - J CRIT CARE

SN - 0883-9441

IS - 6

ER -