Anesthesia & Clinical Research
Open Access

Abstract

Predictive Accuracy of Maximal Inspiratory Pressure, Airway Occlusion Pressure and its Ratio for Successful Liberation from Mechanical Ventilation

Huda Fahmy and Sayed Kinawy

Background: Liberation from mechanical ventilation in critically ill patients is an integration of art and science. Most critical-care clinicians have tried to find weaning parameters which correctly predict the outcome of weaning from mechanical ventilation in those patients.

Aim of the work: To study the accuracy of the respiratory muscle power indices including (Pi_max, P_0.1 and lastly P_0.1/Pi_max ratio) as predictors for successful weaning outcome.

Patients and Methods: This prospective observational study included fifty patients who required invasive mechanical ventilation for at least 24 hours in the Surgical Intensive Care Unit (SICU) and met the criteria of the weaning protocol. The patients were classified according to the fate of spontaneous breathing trial (SBT) into a successful weaned group (30 patients) and a failed weaned group (20 patients).

Results: There was no significant difference regarding the demographic and clinical data between the two groups. Pi_max, P_0.1, and P_0.1/Pi_max ratio were considerably different between the two groups of weaning (P value<0.05). Pi_max with a cutoff value ≤ -22 showed the greatest sensitivity, PPV, NPV, and accuracy (91.67, 87.3, 87.2 and 87.25 respectively) compared with the other weaning indices (P_0.1, and P_0.1/Pi_max ratio) as well as the AUC was highly precise (0.93).

Conclusion: Pi_max with a cutoff value less than -22 cm H₂O is a powerful predictor for successful weaning achievement in mechanically ventilated patients.