| Patients' prediction of extubation success. | |
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MedLine Citation:
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PMID: 20689928 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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PURPOSE: The spontaneous breathing trial (SBT)-relying on objective criteria assessed by the clinician-is the major diagnostic tool to determine if patients can be successfully extubated. However, little is known regarding the patient's subjective perception of autonomous breathing. METHODS: We performed a prospective observational study in 211 mechanically ventilated adult patients successfully completing a SBT. Patients were randomly assigned to be interviewed during this trial regarding their prediction of extubation success. We compared post-extubation outcomes in three patient groups: patients confident (confidents; n = 115) or not (non-confidents; n = 38) of their extubation success and patients not subjected to interview (control group; n = 58). RESULTS: Extubation success was more frequent in confidents than in non-confidents (90 vs. 45%; p < 0.001/positive likelihood ratio = 2.00) or in the control group (90 vs. 78%; p = 0.04). On the contrary, extubation failure was more common in non-confidents than in confidents (55 vs. 10%; p < 0.001/negative likelihood ratio = 0.19). Logistic regression analysis showed that extubation success was associated with patient's prediction [OR (95% CI): 9.2 (3.74-22.42) for confidents vs.non-confidents] as well as to age [0.72 (0.66-0.78) for age 75 vs. 65 and 1.31 (1.28-1.51) for age 55 vs. 65]. CONCLUSIONS: Our data suggest that at the end of a sustained SBT, extubation success might be correlated to the patients' subjective perception of autonomous breathing. The results of this study should be confirmed by a large multicenter trial. |
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Authors:
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Andreas Perren; Marco Previsdomini; Michael Llamas; Bernard Cerutti; Sandor Györik; Giorgio Merlani; Philippe Jolliet |
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Publication Detail:
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Type: Journal Article Date: 2010-08-06 |
Journal Detail:
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Title: Intensive care medicine Volume: 36 ISSN: 1432-1238 ISO Abbreviation: Intensive Care Med Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 2045-52 Citation Subset: IM |
Affiliation:
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Intensive Care, Department of Intensive Care, Ente Ospedaliero Cantonale, Ospedale Regionale Bellinzona e Valli, 6500, Bellinzona, Switzerland. andreas.perren@eoc.ch |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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