EmÃdio Jorge Santos Lima
Salvador University, Brazil
Title: Respiratory rate as an important predictor of weaning from mechanical ventilation
Biography
Biography: EmÃdio Jorge Santos Lima
Abstract
Background: There is not an ideal predictor of weaning from mechanical ventilation (MV). In a large meta-analysis, despite methodological limitation, respiratory rate (RR) was considered a promising predictor. I have published one study that evaluates RR as a predictor of weaning failure from MV in 2012. Methods: We prospectively evaluated 166 patients scheduled for weaning from MV. RR was compared with the following outcomes: weaning success/failure or extubation failure. Results: Weaning success was present in 76.5% and weaning failure in 17.5% of patients. There were 6% of reintubations. The predictive power for RR weaning failure, RR best cut-off point > 24 breaths per minute (bpm), was: sensitivity 100%, specificity 85%, and accuracy 88% (ROC curve, p<0.0001). Of the patients with weaning failure, 100% were identified by RR during screening (RR cut-off >24 bpm). There were 15% false positives, weaning successes with RR>24 bpm. Conclusion: RR was an effective predictor of weaning failure. The best cut-off point was RR >24 bpm, which differed from those reported in the literature (35 and 38 bpm). Only 6% of patients were reintubated, but RR or other weaning criteria did not identify them.