Usage of B-type natriuretic peptide for prediction of weaning outcome by spontaneous breathing trial

Maraghi, S. El; Hosny, Mohamed; Samir, M.Khaled; Radwan, Waheed

doi:10.1016/j.ejcdt.2014.04.003

Cited by 11 publications

(19 citation statements)

References 34 publications

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“…The present study contradicts those from many studies (9,10,11,20,21,25,27,28) in which an association between BNP levels and the result of patien-t´s SBT was found. This could be related to the duration of SBT.…”

Section: Discussioncontrasting

confidence: 99%

“…The success rate of extubation for the 105 patients submitted to an SBT and two BNP assessments was 81%, higher than the 54% success rate reported in the national multicentric study (5) , and the 53.3% and 62.5% success rate in two other international studies (20,21) . On the other hand, 19% of the patients in the present study required tracheal reintubation and were considered failed extubation cases, which was compatible with numbers seen in other national and international studies that reported a 6.1 to 28% rate of patient reintubation (5,6,21,22,23) .…”

Section: Discussionmentioning

confidence: 59%

“…This could be related to the duration of SBT. An SBT performed in less than 2 hours would not trigger a cardiac overload that would release a level of BNPs that could identify patients who will probably undergo failed extubation (11,20,21,28,29) . Based on each patient´s condition and response, as indicated in BRMV 2013 (3) , the duration of SBT in the present study varied from 30 to 120 minutes.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of clinical and laboratorial parameters and the usefulness of the Brain Natiuretic Peptide as a predictor for successful extubation in the ICU

Martins

El-Fakhouri

Conterno

et al. 2021

Medicina (Ribeirão Preto)

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Introduction: Identification of predictors for successful extubation in an Intensive Care Unity and use of Brain Natriuretic Peptides (BNP) in predicting mechanical ventilation weaning and extubation outcome.Aims: Evaluation of the effect of variables such as patient´s age, severity score, use of sedation, use of vasoactive drugs, hydric balance, blood gas data, days under mechanical ventilation, the occurrence of adverse events and plasma BNP levels on the success of extubation.Method: A prospective cohort study of adult patients admitted to a 12- bed-general ICU, from April 1st 2016 to August 10th 2017, under mechanical ventilation for > 24 h, accompanied until discharge or death. Clinical variables were analyzed and BNP was assessed before initiation of Spontaneous Breathing Trial (SBT) and then again before extubation. Statistical Analysis: a descriptive and comparative data analysis, univariate and logistic regressionanalysis for verification of variables independently related to successful extubation (p < 0.05).Results: Study of 105 patients, mean age of 53.9 ± 19.8 years, 81% of success in extubation; the overall mortality rate of 11.4%; variables associated to successful extubation: age, APACHE II, SAPS II, days of hospitalization before ICU admittance, days under mechanical ventilation, days of stay in ICU and occurrence of nosocomial infection (p < 0.05); BNP levels were lower in patients with successful extubation although not statistically significant;multivariate analysis showed that patient’s age and days of hospitalization before ICU admittance were each independently linked to extubation failure; APACHE II score and days of hospitalization before ICU admittance were each independently associated to risk of death.Conclusion: Despite being older and with higher severity scores, patients had a higher success rate in extubation than found in similar studies. However, the mortality rate in cases of failed extubation was higher. Data obtained was in agreement to studies that suggested that patient´s age, severity score, days of hospitalization before ICU admittance, days of stay in ICU, days under MV and infection occurrence were all variables associated as much extubation failure as to risk of death. A direct association between BNP levels and successful extubation and the usefulness of assessing BNP in the conduction of WMV was not confirmed.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

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Assessment of clinical and laboratorial parameters and the usefulness of the Brain Natiuretic Peptide as a predictor for successful extubation in the ICU

Martins

El-Fakhouri

Conterno

et al. 2021

Medicina (Ribeirão Preto)

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“…This finding was in agreement with previous studies by El Maraghi et al, 2014 andChiwhane &Diwan, 2016 which showed significant difference between both groups as regards PO2 pre-weaning trial and during weaning trial.…”

Section: Discussionsupporting

confidence: 94%

Assessment of Some Predictors of Weaning from Mechanical Ventilation in Acutely Intoxicated Patients Admitted to the Poison Control Center-Ain Shams University

Assaf

Halawa

Azab

et al. 2019

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Background: Respiratory failure is a common complication of poisoning with significant morbidity and mortality. Mechanical ventilation is life saving. Weaning is the process of liberating patient from mechanical ventilatory support. Interleukin-6 (IL-6) and C-reactive protein (CRP) are inflammatory mediators, released in response to many stressful conditions as weaning from mechanical ventilation.

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“…Furthermore, some patients who tolerate a SBT under spontaneous or supported breathing scenarios (CPAP =5 cmH 2 O and PS =5 cmH 2 O) may develop respiratory dysfunction postextubation that necessitates intervention (non-invasive or invasive ventilation) (43). Extubation failure rates in patients who passed an SBT have been reported at 16-20% (56,57). Thus, it should be noted that addition of the RSBI to the SBT, with all the listed challenges in the literatures, is a more precise tool than SBT alone.…”

Section: Rsbi Validitymentioning

confidence: 99%

A rapid shallow breathing index threshold of 85 best predicts extubation success in chronic obstructive pulmonary disease patients with hypercapnic respiratory failure

Goharani¹,

Vahedian‐Azimi²,

Galal³

et al. 2019

J. Thorac. Dis

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Background: The rapid shallow breathing index (RSBI) is used clinically to help predict a patient's likelihood of successful liberation from mechanical ventilation (MV). However, the traditional threshold (<105 breaths/min/L) may underperform in patients with chronic obstructive pulmonary disease (COPD).We sought to determine the optimal RSBI threshold for COPD patients to improve the diagnostic accuracy for predicting successful ventilator liberation. Methods: This was a prospective observational multicenter study of COPD patients [according to Global initiative for Chronic Obstructive Lung Disease (GOLD) criteria] admitted to the Medical ICUs of eight academic medical centers. All patients were intubated for hypercapnic respiratory failure and met the American Thoracic Society/European Respiratory Society guidelines to participate in a weaning trial. Ventilator weaning was conducted according to a defined protocol. RSBI was measured through the ventilator after 120 minutes of spontaneous breathing trial (SBT). Results: Ninety patients were included (39 males and 51 females). Forty-three patients (48%) were successfully extubated whereas 47 patients (52%) failed extubation. Significant differences were observed between groups for duration-of-intubation [duration of intubation (DoI); P<0.0001], spontaneous tidal volume (VT) (P=0.03), and the ratio of dynamic-to-static compliance (P=0.005). The RSBI threshold of ≤85 breaths/min/L performed best: area under curve (AUC) receiver operating characteristic (ROC) curves 0.91, sensitivity 95.6%, specificity 90.4%, positive predictive value (PPV) 95.5%, and negative predictive value (NPV) 90.6%., positive likelihood ratio (LR+) 5.48, negative likelihood ratio (LR−) 0.25, and the diagnostic accuracy 91.7%. In post-ROC analyses, DoI and hospital length-of-stay (LOS) did not impact performance. Conclusions: In COPD patients intubated with hypercapnia, RSBI ≤85 breaths/min/L outperformed the widely used threshold <105 breaths/min/L, yielding a 95.5% probability of extubation success, independent 1224

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Usage of B-type natriuretic peptide for prediction of weaning outcome by spontaneous breathing trial

Cited by 11 publications

References 34 publications

Assessment of clinical and laboratorial parameters and the usefulness of the Brain Natiuretic Peptide as a predictor for successful extubation in the ICU

Assessment of clinical and laboratorial parameters and the usefulness of the Brain Natiuretic Peptide as a predictor for successful extubation in the ICU

Assessment of Some Predictors of Weaning from Mechanical Ventilation in Acutely Intoxicated Patients Admitted to the Poison Control Center-Ain Shams University

A rapid shallow breathing index threshold of 85 best predicts extubation success in chronic obstructive pulmonary disease patients with hypercapnic respiratory failure

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