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Predictors of spontaneous breathing outcome in mechanically ventilated chronic obstructive pulmonary disease patients

Egyptian Journal of Bronchology volume 13, pages 335–342 (2019)Cite this article

Abstract

Background

Morbidity and mortality due to chronic obstructive pulmonary disease (COPD) represents a worldwide pandemic, with exacerbations necessitating mechanical ventilation representing important aspects of disease management. Attempts to search for better weaning indices (WIs) is a continuous process. This study seeks for best index predicting weaning outcome in COPD patients.

Patients and methods

2One hundred and fifty COPD patients (110 men, 40 women) receiving mechanical ventilation were included in this study. Weaning process as early as possible was considered. Patients who were receiving mechanical ventilation of more than 24 h underwent daily screen of subjective and objective indices for weaning readiness. Measurements done on admission and through weaning process included: acute physiology and chronic health evaluation II score, simplified acute physiology score II, CORE (compliance, oxygenation, respiration, and effort) index, rapid shallow breathing index (RSBI), WI, integrative weaning index (IWI), compliance, rate, oxygenation, and pressure (CROP) index and P0.1/negative inspiratory force index.

Results

There is a highly significant difference between weaning success and failure groups regarding the CORE index, RSBI, WI, IWI, CROP index, and P0.1/negative inspiratory force. CORE index had the highest area under the curve (0.929) which was significantly higher than other indices included in the study.

Conclusion

RSBI, WI, IWI, and CROP index displayed moderate accuracy in predicting spontaneous breathing trial success in COPD patients. CORE index showed better diagnostic performance in predicting successful weaning and had the highest accuracy.

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Authors and Affiliations

  1. Department of Chest Diseases, Faculty of Medicine, Assiut University, Assiut, Egypt

    Suzan S. Sayed, Aliaë A. Mohammed Hussein & Waleed G. Elddin Khaleel MSc

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  1. Suzan S. Sayed
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  2. Aliaë A. Mohammed Hussein
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  3. Waleed G. Elddin Khaleel MSc
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Correspondence to Waleed G. Elddin Khaleel MSc.

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Sayed, S.S., Mohammed Hussein, A.A. & Elddin Khaleel, W.G. Predictors of spontaneous breathing outcome in mechanically ventilated chronic obstructive pulmonary disease patients. Egypt J Bronchol 13, 335–342 (2019). https://doi.org/10.4103/ejb.ejb_81_18

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  • DOI: https://doi.org/10.4103/ejb.ejb_81_18

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