Abstract
Background:
Intubated patients with stable vital sign, well weaning profile and spontaneous breathing test are the most important key points to be extubated. The aim of present study is to validate the influence factors of the successful extubation of patients in intensive care unit.
Methods:
Thirty-eight intubated patients in the intensive care unit of Show Chwan Memorial Hospital, a regional hospital, were enrolled in this retrospective study from November, 2019 to February, 2020. All of them used mechanical ventilator support for more than 3 days. The patients’ characteristics, including age, body height, body weight, neck circumference and the weaning profile parameters were collected, and the length of intubation days. In addition, cuff leak test value was measured before extubation, by calculating the volume of air leakage after the endotracheal tube cuff was deflated while the ventilator was set as the volume-assist-control mode. Successful extubation was defined as no re-intubation in the following 28 days. Statistic t test and independent sample test were applied to assess the correlation between these parameters and the success rate of extubation.
Results:
The influence factors of better success rate for extubation include the neck circumference (P=0.005, 95% CI 34.8 to 37.2), and the cuff leak test (P=0.015,95% CI 174.7 to 340.5). In addition, we found that the patients with neck circumference more than 37.5 centimeters may have higher risk of extubation failure (Fisher exact test P <.001).
Conclusions:
Patients with the smaller neck circumference, the higher cuff leak volume have a better extubation success rate.
Risk Factors of Cuff Leak Test
Extubation success
Extubation failure
P valve
Duration of MV(Days)
5.9±4.9
7.2±4.0
0.466
Age
61.6±17.4
60.3±16.8
0.908
Body hight(cm)
161.9±8.1
165.1±8.4
0.297
Body weight(kg)
63.0±13.9
70.5±15.8
0.167
BMI
23.9±4.5
26±5.9
0.263
Ideal body weight
57.4±5.6
60.1±6.0
0.205
MIP
-40.2±12.9
-42.3±33.6
0.850
MEP
46.4±21.0
47.0±23.6
0.942
Respiratory rate
18.4±5.4
21.4±8.2
0.199
Tidal volume
349.2±182.1
437.6±264.9
0.255
Minute volume
6.5±2.6
8.1±3.6
0.138
Rapid shallow breathing index
62.5±28.4
73.2±59.4
0.596
Cuff leak test
257.6±82.9
177.6±84.0
0.014
Neck circumference
36.0±1.2
37.7±1.8
0.003
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