A randomized, controlled trial of the role of weaning predictors in clinical decision making*

Abstract

Including a weaning predictor (f/Vt) in a protocol prolonged weaning time. In addition, the predictor did not confer survival benefit or reduce the incidence of extubation failure or tracheostomy. The results of this study indicate that f/Vt should not be used routinely in weaning decision making.

Preliminary Evaluation of a New Index to Predict the Outcome of a Spontaneous Breathing Trial

“…29 During the SBT the RSBI was also found to stay within the normal range even though the repeated measurements in the esophageal pressure swings showed an increase in respiratory effort and weaning failure. 30 In a recent study, 31 the use of the RSBI did not improve weaning outcome, and it delayed weaning for 2-3 days. Muscle fatigue during an SBT is a complex process that obviously cannot be well predicted based solely on respiratory rate and V T .…”

Efeitos da aplicação de protocolo de desmame de ventilação mecânica em Unidade Coronária: estudo randomizado

“…Several authors have demonstrated the importance of this result in the evolution of patients [5,12,13,[18][19][20]24,28]. When compared to the first intubation, reintubation increased eight times the risk of pneumonia and from 6 to 12 times the risk of death, being considered an independent predictor of mortality [13,14,19,29,30].…”

“…The daily assessment of the weaning parameters held in the experimental group has been described in the literature as one of the factors responsible for good performance observed using the protocol of SBT [4, 13,[16][17][18]31].…”

“…Several randomized controlled trials in hospitalized patients in general intensive care demonstrated reduction of the period in which patients used to be on mechanical ventilation, lower rates of reintubation and fewer complications when weaning from MV was performed according to specific protocol [5,6,13,[16][17][18][19][20][21][22][23]28].…”

“…In these studies, the non-use of protocol has made the time of extubation become inaccurate, resulting in early extubation and unnecessary prolongation of the duration of the weaning process [5,6,13,[16][17][18][19][20][21][22][23][24][25][26][27].…”