Predictors Of Successful Extubation in Critically Ill Patients: Multicentre Observational Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 499
- 试验地点
- 1
- 主要终点
- Implementation of reintubation within 48 hours after extubation
研究概览
简要总结
Extubation failure can directly worsen patient outcomes. Therefore, the decision to extubate is a critical moment during an intensive care unit (ICU) stay. The decision to extubate is usually made after a weaning readiness test involving spontaneous breathing on a T-piece or low levels of ventilatory assistance. However, extubation failure still occurs in 10 to 20% of patients. The investigators focused on previously reported physiological risk factors, and were able to obtain from common clinical practice: 1) age, 2) underlying cardiovascular disease, 3) underlying respiratory disease or occurrence of pneumonia, 4) rapid shallow breathing index (RSBI), 5) positive fluid balance during the previous 24 hours, 6) the ratio of arterial oxygen partial pressure to fractional inspired oxygen, 7) Glasgow Coma Scale, 8) respiratory tract secretions. The investigators aimed to assess the incidence and risk factors for extubation failure among critically ill patients who passed the 30 min spontaneous breathing test (SBT) using a low level of pressure support (PS) with positive end-expiratory pressure (PEEP), in a prospective multicenter study.
详细描述
Primary Outcome Measures:
Reintubation within 48 hours after extubation (logistic regression will be used to assess the risk factors)
Secondary Outcome Measures:
- Use of non-invasive positive pressure ventilation or nasal high flow within 48 hours after extubation.
- Risk factors for extubation failure, with quantitative variables expressed as means (standard deviation) or medians (interquartiles 25%-75%) and compared using the student t test or Wilcoxon test as appropriate
- Length of ICU and hospital stay, vital status at ICU and hospital discharge, 28-day mortality
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Mechanically ventilated for longer than 24 hours in Intensive Care Units
- •Extubated after successful the 30 min spontaneous breathing test using a low level of pressure support with positive end-expiratory pressure
排除标准
- •Decision not to reintubate
- •Unplanned extubation
- •Extracorporeal circulation
- •Patients who died within 48 hours after extubation
结局指标
主要结局
Implementation of reintubation within 48 hours after extubation
时间窗: 48 hours
logistic regression will be used to identify risk factors
次要结局
- vital status at ICU and hospital discharge, 28-day mortality(28 days)
- Use of non-invasive positive pressure ventilation or nasal high flow within 48 hours after extubation(48 hours)
- Length of ICU and hospital stay,(28 days)
