Made Wirga Wirgunatha, Bianca Jeanne, Tjokorda Gde Agung Senapathi, Putu Agus Surya Panji, I Wayan Suranadi
{"title":"重症监护病房自主呼吸试验中中心静脉血氧饱和度变化对拔管成功的预测作用。","authors":"Made Wirga Wirgunatha, Bianca Jeanne, Tjokorda Gde Agung Senapathi, Putu Agus Surya Panji, I Wayan Suranadi","doi":"10.2174/0118743064363511250304050459","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Weaning from mechanical ventilation is an essential step in the care of critically ill patients. Central venous oxygen saturation (ScvO<sub>2</sub>) could reflect tissue oxygenation.</p><p><strong>Objective: </strong>The evaluation of the difference in ScvO<sub>2</sub> values at the beginning and end of the Spontaneous Breathing Trial (SBT) can be used as a predictor of successful extubation in critically ill patients.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in the ICU of Prof. Dr. I.G.N.G. Ngoerah Hospital from July to August 2024. This study involved 42 adult patients aged 18-65 who were using mechanical ventilation during their admission to the ICU. All patients had central venous access, were clinically ready for mechanical ventilation weaning, and could attempt SBT for 30-120 minutes with a rapid shallow breathing index (RSBI) of less than 105.</p><p><strong>Results: </strong>All patients underwent 30-120 minutes of SBT. ScvO<sub>2</sub> levels were measured at the beginning of SBT (first minute) and at 30 minutes after SBT started, and the change in ScvO<sub>2</sub> level was recorded (ΔScvO<sub>2</sub>). Patients with RSBI < 105 measured during SBT were extubated. Extubation failure was defined as the need for re-intubation, or patients died within 48 hours after extubation. Of 42 patients, 37 patients (89.1%) were successfully extubated. There was a significant difference in ΔScvO<sub>2</sub> between successfully extubated patients and those who failed \u2028(-2.89±1.63 <i>vs.</i> -8.2±4.27; p=0.049). The ROC curve analysis showed that a decrease in ScvO<sub>2</sub> ≤4.5% was the most optimal cut-off for a predictor of successful extubation with a sensitivity of 81.1%, specificity of 60%, positive predictive value of 93.8% and negative predictive value of 70%.</p><p><strong>Conclusion: </strong>The difference in ScvO<sub>2</sub> between the beginning and after 30 minutes of SBT was a valuable early predictor for successful extubation from mechanical ventilation.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"19 ","pages":"e18743064363511"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174941/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Change of Central Vein Oxygen Saturation Level during Spontaneous Breathing Trial as a Predictor of Successful Extubation in Intensive Care Unit.\",\"authors\":\"Made Wirga Wirgunatha, Bianca Jeanne, Tjokorda Gde Agung Senapathi, Putu Agus Surya Panji, I Wayan Suranadi\",\"doi\":\"10.2174/0118743064363511250304050459\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Weaning from mechanical ventilation is an essential step in the care of critically ill patients. Central venous oxygen saturation (ScvO<sub>2</sub>) could reflect tissue oxygenation.</p><p><strong>Objective: </strong>The evaluation of the difference in ScvO<sub>2</sub> values at the beginning and end of the Spontaneous Breathing Trial (SBT) can be used as a predictor of successful extubation in critically ill patients.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in the ICU of Prof. Dr. I.G.N.G. Ngoerah Hospital from July to August 2024. This study involved 42 adult patients aged 18-65 who were using mechanical ventilation during their admission to the ICU. All patients had central venous access, were clinically ready for mechanical ventilation weaning, and could attempt SBT for 30-120 minutes with a rapid shallow breathing index (RSBI) of less than 105.</p><p><strong>Results: </strong>All patients underwent 30-120 minutes of SBT. ScvO<sub>2</sub> levels were measured at the beginning of SBT (first minute) and at 30 minutes after SBT started, and the change in ScvO<sub>2</sub> level was recorded (ΔScvO<sub>2</sub>). Patients with RSBI < 105 measured during SBT were extubated. Extubation failure was defined as the need for re-intubation, or patients died within 48 hours after extubation. Of 42 patients, 37 patients (89.1%) were successfully extubated. There was a significant difference in ΔScvO<sub>2</sub> between successfully extubated patients and those who failed \\u2028(-2.89±1.63 <i>vs.</i> -8.2±4.27; p=0.049). The ROC curve analysis showed that a decrease in ScvO<sub>2</sub> ≤4.5% was the most optimal cut-off for a predictor of successful extubation with a sensitivity of 81.1%, specificity of 60%, positive predictive value of 93.8% and negative predictive value of 70%.</p><p><strong>Conclusion: </strong>The difference in ScvO<sub>2</sub> between the beginning and after 30 minutes of SBT was a valuable early predictor for successful extubation from mechanical ventilation.</p>\",\"PeriodicalId\":39127,\"journal\":{\"name\":\"Open Respiratory Medicine Journal\",\"volume\":\"19 \",\"pages\":\"e18743064363511\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174941/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Respiratory Medicine Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2174/0118743064363511250304050459\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Respiratory Medicine Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/0118743064363511250304050459","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
The Change of Central Vein Oxygen Saturation Level during Spontaneous Breathing Trial as a Predictor of Successful Extubation in Intensive Care Unit.
Background: Weaning from mechanical ventilation is an essential step in the care of critically ill patients. Central venous oxygen saturation (ScvO2) could reflect tissue oxygenation.
Objective: The evaluation of the difference in ScvO2 values at the beginning and end of the Spontaneous Breathing Trial (SBT) can be used as a predictor of successful extubation in critically ill patients.
Methods: This cross-sectional study was conducted in the ICU of Prof. Dr. I.G.N.G. Ngoerah Hospital from July to August 2024. This study involved 42 adult patients aged 18-65 who were using mechanical ventilation during their admission to the ICU. All patients had central venous access, were clinically ready for mechanical ventilation weaning, and could attempt SBT for 30-120 minutes with a rapid shallow breathing index (RSBI) of less than 105.
Results: All patients underwent 30-120 minutes of SBT. ScvO2 levels were measured at the beginning of SBT (first minute) and at 30 minutes after SBT started, and the change in ScvO2 level was recorded (ΔScvO2). Patients with RSBI < 105 measured during SBT were extubated. Extubation failure was defined as the need for re-intubation, or patients died within 48 hours after extubation. Of 42 patients, 37 patients (89.1%) were successfully extubated. There was a significant difference in ΔScvO2 between successfully extubated patients and those who failed (-2.89±1.63 vs. -8.2±4.27; p=0.049). The ROC curve analysis showed that a decrease in ScvO2 ≤4.5% was the most optimal cut-off for a predictor of successful extubation with a sensitivity of 81.1%, specificity of 60%, positive predictive value of 93.8% and negative predictive value of 70%.
Conclusion: The difference in ScvO2 between the beginning and after 30 minutes of SBT was a valuable early predictor for successful extubation from mechanical ventilation.
期刊介绍：
The Open Respiratory Medicine Journal is an Open Access online journal, which publishes research articles, reviews/mini-reviews, letters and guest edited single topic issues in all important areas of experimental and clinical research in respiratory medicine. Topics covered include: -COPD- Occupational disorders, and the role of allergens and pollutants- Asthma- Allergy- Non-invasive ventilation- Therapeutic intervention- Lung cancer- Lung infections respiratory diseases- Therapeutic interventions- Adult and paediatric medicine- Cell biology. The Open Respiratory Medicine Journal, a peer reviewed journal, is an important and reliable source of current information on important recent developments in the field. The emphasis will be on publishing quality articles rapidly and making them freely available worldwide.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
