Prediction of Extubation Failure in COVID-19
Carregando...
Citações na Scopus
3
Tipo de produção
article
Data de publicação
2021
Título da Revista
ISSN da Revista
Título do Volume
Editora
DAEDALUS ENTERPRISES INC
Autores
BRASIL, Eduardo S. de Assis
COSTA, Ladyer G.
SOUSA, Daniel Escossia M.
Citação
RESPIRATORY CARE, v.66, n.8, p.1323-1329, 2021
Resumo
BACKGROUND: S-pO2/F-IO2 may be a reliable noninvasive alternative to the P-aO2/F-IO2 index. Furthermore, the ROX index (ie, the ratio of S-pO2/F-IO2 to breathing frequency) has been validated to predict high-flow nasal cannula failure in subjects under spontaneous breathing. However, these indices have not been tested in subjects with COVID-19 receiving invasive mechanical ventilation. This study aims to verify the correlation between both the ROX index and S-pO2/F-IO2 with P-aO2/F-IO2 and the ratio of P-aO2/F-IO2 to breathing frequency, and to determine the accuracy of the indices that use S-pO2 for the prediction of extubation failure in subjects with COVID-19. METHODS: A prospective cohort study was conducted from May 15, 2020, to June 15, 2020, with subjects with COVID-19 on invasive mechanical ventilation. Indices using S-pO2 in the formula were compared to those using P-aO2. Additionally, the performance of the indices in predicting extubation failure was evaluated. RESULTS: This study included 69 subjects age 64.8 +/- 14.6 y. There were no differences between the median values of the indices, including between the ROX index and P-aO2/F-IO2 to breathing frequency (P = .40) or between P-aO2/F-IO2 and S-pO2/F-IO2 (P = .83). When comparing the ROX index with the P-aO2/F-IO2 index to breathing frequency, they were found to be strongly correlated (R-2 = 0.75 [95% CI 0.6763-0.8152], P < .001). The comparison of P-aO2/F-IO2 with S-pO2/F-IO2 revealed R-2 = 0.70 (95% CI 0.563-0.749, P < .001). The area under the receiver operating characteristic curve for the ROX index to determine extubation failure was 0.74 (P = .01), whereas for S-pO2/F-IO2 it was 0.78 (P < .001). CONCLUSIONS: The indices presented a good correlation in subjects with COVID-19 on invasive mechanical ventilation, and both the ROX index and S-pO2/F-IO2 can discriminate extubation failure in this population.
Palavras-chave
COVID-19, mechanical ventilation, pulse oximeter, critical care, respiratory failure, extubation failure
Referências
- BERNARD GR, 1994, AM J RESP CRIT CARE, V149, P818, DOI 10.1164/ajrccm.149.3.7509706
- Bilan N, 2015, J CARDIOVASC THORAC, V7, P28, DOI 10.15171/jcvtr.2014.06
- Botta M, 2021, LANCET RESP MED, V9, P139, DOI 10.1016/S2213-2600(20)30459-8
- Brown SM, 2016, CHEST, V150, P307, DOI 10.1016/j.chest.2016.01.003
- Chen W, 2015, CHEST, V148, P1477, DOI 10.1378/chest.15-0169
- Festic E, 2015, J INTENSIVE CARE MED, V30, P209, DOI 10.1177/0885066613516411
- Goh KJ, 2020, J INTENSIVE CARE, V8, DOI 10.1186/s40560-020-00458-z
- Hill NS, 2019, AM J RESP CRIT CARE, V199, P1300, DOI 10.1164/rccm.201901-0079ED
- Johannigman JA, 1997, SURGERY, V122, P737, DOI 10.1016/S0039-6060(97)90081-7
- Karim HMR, 2019, AM J RESP CRIT CARE, V200, P116, DOI 10.1164/rccm.201902-0419LE
- Kim BK, 2020, RESP CARE, V65, P1276, DOI 10.4187/respcare.07403
- Patel M, 2020, ROX INDEX PREDICTS I ROX INDEX PREDICTS I
- Ranieri VM, 2012, JAMA-J AM MED ASSOC, V307, P2526, DOI 10.1001/jama.2012.5669
- Rice TW, 2007, CHEST, V132, P410, DOI 10.1378/chest.07-0617
- Roca O, 2019, AM J RESP CRIT CARE, V199, P1368, DOI 10.1164/rccm.201803-0589OC
- Roca O, 2016, J CRIT CARE, V35, P200, DOI 10.1016/j.jcrc.2016.05.022
- Spinelli E, 2020, J CRIT CARE, V58, P130, DOI 10.1016/j.jcrc.2019.08.013
- Ziehr DR, 2020, AM J RESP CRIT CARE, V201, P1560, DOI 10.1164/rccm.202004-1163LE
- Zucman N, 2020, INTENS CARE MED, V46, P1924, DOI 10.1007/s00134-020-06177-1