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J Crit Care. 2009 Sep;24(3):441-6. doi: 10.1016/j.jcrc.2009.01.007. Epub 2009 Mar 27.

Evaluation of maximal inspiratory pressure, tracheal airway occlusion pressure, and its ratio in the weaning outcome.

Author information

1
Intensive Care Unit, Hospital de Clínicas de Niterói, Centro-Niterói, Rio de Janeiro CEP 24020-090, Brazil. snnemer@urbi.com.br

Abstract

PURPOSE:

The objective of this study is to evaluate the predictive performance of maximal inspiratory pressure (Pimax), airway occlusion pressure (P 0.1), and its ratio (P 0.1/Pimax) in the weaning outcome.

MATERIALS AND METHODS:

Seventy patients on mechanical ventilation for more than 24 hours, who fulfilled weaning criteria, were prospectively evaluated. Pimax less than -25 cm H(2)O, P 0.1 less than 4.2 cm H(2)O, and P 0.1/Pimax less than 0.14 were evaluated in all patients before spontaneous breathing trials. The receiver operating characteristic (ROC) curve was calculated to evaluate the predictive performance of each index.

RESULTS:

Pimax presented the area under the ROC curves smaller than those for P 0.1 and P 0.1/Pimax (0.52 x 0.76 and 0.52 x 0.78; P = .004 and P = .0006, respectively), being the criteria of worst performance. P 0.1/Pimax presented excellent predictive performance in weaned patients, with sensitivity of 98.08, but with the area under the ROC curves only slightly larger than those for P 0.1 (0.78 x 0.76, respectively; P = .69).

CONCLUSION:

In our study, P 0.1 and P 0.1/Pimax ratio were moderately accurate, whereas Pimax was less accurate in predicting the weaning outcome.

PMID:
19327955
DOI:
10.1016/j.jcrc.2009.01.007
[Indexed for MEDLINE]

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