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Prediction of successful de-cannulation of tracheostomised patients in medical intensive care units.

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اقرأ على الانترنت اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • المصدر:
      Publisher: BioMed Central Ltd Country of Publication: England NLM ID: 101090633 Publication Model: Electronic Cited Medium: Internet ISSN: 1465-993X (Electronic) Linking ISSN: 14659921 NLM ISO Abbreviation: Respir Res Subsets: MEDLINE
    • بيانات النشر:
      Publication: 2001- : London : BioMed Central Ltd.
      Original Publication: London : Current Science Ltd., c2000-
    • الموضوع:
      Chest Tubes* ; Decision Support Techniques* ; Device Removal*/adverse effects ; Respiration, Artificial*/adverse effects ; Ventilator Weaning*/adverse effects; Tracheostomy/*instrumentation; Adult ; Aged ; Aged, 80 and over ; Equipment Design ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Tracheostomy/adverse effects ; Treatment Outcome
    • نبذة مختصرة :
      Background: Limited data are available on practical predictors of successful de-cannulation among the patients who undergo tracheostomies. We evaluated factors associated with failed de-cannulations to develop a prediction model that could be easily be used at the time of weaning from MV.
      Methods: In a retrospective cohort of 346 tracheostomised patients managed by a standardized de-cannulation program, multivariable logistic regression analysis identified variables that were independently associated with failed de-cannulation. Based on the logistic regression analysis, the new predictive scoring system for successful de-cannulation, referred to as the DECAN score, was developed and then internally validated.
      Results: The model included age > 67 years, body mass index < 22 kg/m 2 , underlying malignancy, non-respiratory causes of mechanical ventilation (MV), presence of neurologic disease, vasopressor requirement, and presence of post-tracheostomy pneumonia, presence of delirium. The DECAN score was associated with good calibration (goodness-of-fit, 0.6477) and discrimination outcomes (area under the receiver operating characteristic curve 0.890, 95% CI 0.853-0.921). The optimal cut-off point for the DECAN score for the prediction of the successful de-cannulation was ≤ 5 points, and was associated with the specificities of 84.6% (95% CI 77.7-90.0) and sensitivities of 80.2% (95% CI 73.9-85.5).
      Conclusions: The DECAN score for tracheostomised patients who are successfully weaned from prolonged MV can be computed at the time of weaning to assess the probability of de-cannulation based on readily available variables.
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    • Grant Information:
      SMO1180151 Samsung Medical Center
    • Contributed Indexing:
      Keywords: Artificial respiration; Device removal; Intensive care unit; Predictive value of tests; Tracheostomy
    • الموضوع:
      Date Created: 20210429 Date Completed: 20211123 Latest Revision: 20211123
    • الموضوع:
      20240829
    • الرقم المعرف:
      PMC8080087
    • الرقم المعرف:
      10.1186/s12931-021-01732-w
    • الرقم المعرف:
      33910566