Escore visage, pressão inspiratória máxima e pico de fluxo de tosse apresentam excelente acurácia e sensibilidade para predizer a extubação de pacientes neurocríticos

Objective: To evaluate predictive parameters of success in weaning from mechanical ventilation and extubation in patients with acute brain injury. Methods: This descriptive, analytical and inferential study was carried out with 64 neurocritical patients assisted at an intensive care unit. The patien...

Descripción completa

Detalles Bibliográficos
Autor: Muzette, Flavia Manhani
Tipo de recurso: tesis de maestría
Estado:Versión publicada
Fecha de publicación:2021
País:Brasil
Institución:Universidade Federal de Mato Grosso do Sul (UFMS)
Repositorio:Repositório Institucional da UFMS
Idioma:portugués
OAI Identifier:oai:repositorio.ufms.br:123456789/3835
Acceso en línea:https://repositorio.ufms.br/handle/123456789/3835
Access Level:acceso abierto
Palabra clave:Lesões Encefálicas
Cuidados Críticos
Ventiladores Mecânicos
Respiração Artificial
Desmame do Respirador
Extubação
Descripción
Sumario:Objective: To evaluate predictive parameters of success in weaning from mechanical ventilation and extubation in patients with acute brain injury. Methods: This descriptive, analytical and inferential study was carried out with 64 neurocritical patients assisted at an intensive care unit. The patients, all with acute brain injury, were divided as to the success or failure of extubation. The assessments involved VISAGE score, analysis of maximum inspiratory and expiratory pressure, peak cough flow, airway occlusion pressure in 0.1 second and airway occlusion pressure relationship with maximum inspiratory pressure. Logistic regression tests were applied in order to measure the predictive factors linked to the success and failure of weaning and extubation of the patient. Statistical significance was set at 5%. Results: Patients with extubation failure had a longer hospital stay in intensive care than patients with success. Logistic regression analysis indicated that VISAGE score, maximum inspiratory pressure and peak cough flow are consistent factors in distinguishing success and failure from extubation in 74.30% of cases. The statistical model with these variables showed accuracy of 79.69% and sensitivity of 95.83%. Conclusion: VISAGE score, maximum inspiratory pressure and peak cough flow are highly accurate and sensitive in predicting success or failure of ventilatory weaning and extubation of the neurocritical patient. Research with other variables should be carried out with the aim of further expanding the accuracy of the success of ventilatory weaning and extubation.