Mean platelet volume is useful for predicting weaning failure: a retrospective, observational study

Abstract

Background To evaluate the usefulness of mean platelet volume (MPV), a marker of inflammation and stress, for predicting weaning failure in patients undergoing invasive mechanical ventilation (IMV) compared to traditional inflammation markers. Methods The retrospective observational study including patients who received IMV and underwent spontaneous breathing trial (SBT) was conducted in ICU at Beijing Chao-Yang hospital in China from January, 2013 to December, 2019. According to the weaning outcome, MPV, leukocyte count and C-reaction protein(CRP) were compared between weaning failure and weaning success group. Receiver-operating characteristics (ROC) curves and multivariate logistical regression analysis were constructed to analyze the value of these inflammatory markers for predicting weaning failure. Results A total of 261 patients were enrolled in the study and 54 patients (20.7%) experienced weaning failure (45 SBT failure and 9 extubation failure after successful SBT). MPV was a better predictor for weaning failure (AUC 0.777;95%CI, 0.722–0.826) than leukocyte count (AUC 0.6;95%CI,0.538–0.66) and CRP (0.627;95%CI,0.565–0.685). The cutoff value of MPV for predicting weaning failure was 11.3 fl with sensitivity 55.56%, specificity 87.92%, and diagnostic accuracy 81.22%. According to multivariate logistic regression analyses, MPV > 11.3 fl was an independent risk factor for predicting weaning failure. Conclusions MPV could be a more valuable marker for predicting weaning failure. and the patients with MPV > 11.3 fl should be attentively evaluated before weaning since they are at high risk of weaning failure, and it would be auspicable for those patients to undergo a noninvasive ventilation or high-flow nasal cannula oxygen therapy after extubation or even an early tracheostomy.

NT-proBNP change is useful for predicting weaning failure from invasive mechanical ventilation among postsurgical patients: a retrospective, observational cohort study

“…It has been reported that there were 14.5% of postoperative patients among the patients receiving mechanical ventilation in intensive care unit(ICU) [ 3 ]. Although postsurgical patients tended to have lower weaning failure rate compared to medical patients in our previous study [ 4 ], those patients still face much challenge during weaning process. There are multiple mechanisms of weaning failure [ 5 – 7 ].…”

“…All postsurgical patients intubated and mechanically ventilated for not less than 12 h were considered eligible for the study if they fulfilled the following [ 4 , 23 ]: resolution of the underlying causes of acute respiratory failure; adequate cough reflex; absence of excessive tracheobronchial secretion; adequate oxygenation (e.g., arterial oxygen saturation > 90% or arterial oxygen tension/fraction of inspired oxygen [PaO 2 /FiO 2 ] ≥ 150 mmHg, both on the FiO 2 of ≤ 0.4 and the positive end-expiratory pressure of ≤ 8 cmH 2 O); adequate ventilatory status (e.g., respiratory rate [RR] ≤ 35 breaths/min with tidal volume ≥ 5 mL/kg of predicted body weight and no significant respiratory acidosis); stable hemodynamics (e.g., heart rate [HR] < 120 beats/min; systolic blood pressure [SBP], 90–160 mmHg; and no or minimal vasopressor use); adequate mentation (e.g., arousable or glasgow coma scale ≥ 13 with no continuous sedative infusions); body temperature < 38 ℃; hemoglobinemia ≥ 80 g/L; and acceptable electrolytes. The postsurgical patients included patients admitted to the ICU immediately after surgery and patients transferred to ICU within 1 week after surgery.…”

“…Age < 18 years; pregnancy; tracheotomy or other upper airway disorders; mechanically ventilated less than 12 h; abandoned before extubation; neuromuscular disease; decision to limit active treatment; chronic kidney disease; chronic heart failure; and incomplete data. The inclusion and exclusion criteria were described in our previous research [ 4 , 23 ].…”

Mean platelet volume as a predictive biomarker for in-hospital mortality in patients receiving invasive mechanical ventilation

“…This retrospective, observational, single center study included patients receiving IMV not less than 24 h admitted to the ICU of Beijing Chao-Yang Hospital from January, 2014 to January, 2019. The following patients were excluded: Age < 18 years; pregnancy; tracheotomy or other upper airway disorders; mechanically ventilated less than 24 h; neuromuscular disease; decision to abandon or limit active treatment; incomplete data [ 23 ].…”

“…Complete blood cell counts were measured by an automatic blood analyzer. CRP concentrations were measured using immunoscatter turbidimetry by Goldsite Aristo (Goldsite, Ltd., China), and the normal value of CRP ranges from 0 to 5 mg/L [ 23 ]. Acute kidney injury(AKI), defined according to established criteria [ 24 ]; septic shock, defined according to established criteria [ 25 ].…”