Respiratory muscle assessment in predicting extubation outcome in patients with stroke

Antonio A M Castro, Felipe Cortopassi, Russell Sabbag, Luis Torre-Bouscoulet, Claudia Kümpel, Elías Ferreira Porto
Archivos de Bronconeumología 2012, 48 (8): 274-9

BACKGROUND: Patients with cerebral infarction often present impaired consciousness and unsatisfactory extubation. We aimed to assess the respiratory mechanics components that might be associated with the success of extubation in stroke patients.

METHODS: Twenty consecutive patients with stroke who needed mechanical ventilation support were enrolled. The maximal inspiratory pressure, gastric and the esophageal pressure (Pdi/Pdimax), minute volume, respiratory rate, static compliance, airway resistance, rapid and superficial respiration index (RSRI), inspiratory time/total respiratory cycle (Ti/Ttot), and PaO(2)/FiO(2) were measured.

RESULTS: The group who presented success to the extubation process presented 12.5±2.2=days in mechanical ventilation and the group who failed presented 13.1±2=days. The mean Ti/Ttot and Pdi/Pdimax for the failure group was 0.4±0.08 (0.36-0.44) and 0.5±0.7 (0.43-0.56), respectively. The Ti/Ttot ratio was 0.37±0.05 (0.34-0.41; p=0.0008) and the Pdi/Pdimax was 0.25±0.05 for the success group (0.21-0.28; p<0.0001). A correlation was found between Pdi/Pdimax ratio and the RSRI (r=0.55; p=0.009) and PaO(2)/FiO(2) (r=-0.59; p=0.005). Patients who presented a high RSRI (OR, 3.66; p=0.004) and Pdi (OR, 7.3; p=0.002), and low PaO(2)/FIO(2) (OR, 4.09; p=0.007), Pdi/Pdimax (OR, 4.12; p=0.002) and RAW (OR, 3.0; p=0.02) developed mechanical ventilation extubation failure.

CONCLUSION: Muscular fatigue index is an important predicting variable to the extubation process in prolonged mechanical ventilation of stroke patients.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"