Guerrero THE, Gómez GN, García POA, Santiago GF, Jiménez CC, González CPL

Language: Spanish
References: 20
Page: 593-599
PDF size: 255.64 Kb.

ABSTRACT

Introduction: little information is available on the processes of weaning from mechanical ventilation following severe neurological injury. The strategies employed have been extrapolated from research and protocols obtained from populations without neurocritical pathology. Objective: to identify the best predictor associated with ventilatory weaning outcome in neurocritical patients. Material and methods: an observational, analytical, longitudinal and ambispective study was conducted in a tertiary care hospital with a total sample of 56 patients. Correlation tests, ROC curves and a multiple linear regression model were performed. Setting: neurocritical patients with invasive mechanical ventilation (IMV) in the Intensive Care Unit (ICU). Intervention: a weaning protocol was recorded with the following. Variables of interest: weaning outcome (failure success), VISAGE, Four, NIF, P0.1, Peak flow, Yang/Tobin. Results: 25 (44.64%) patients had successful weaning and 31 (55.36%) patients failed. Days of mechanical ventilation had a strong correlation with weaning failure (r 0.856 p < 0.001). Neurological assessment by Four scale at weaning had a moderate negative correlation (r -0.474 p < 0.001). In the simple linear regression an R 0.474 was obtained, which increases to R 0.938 with the sum of the other predictor variables. Conclusions: of the predictor tests for extubation, the VISAGE Scale, P0.1 test and peak flow are more relevant for obtaining a higher success rate in weaning patients with neurological disease with IMV who will undergo a weaning process.

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