Cough Peak Flow for Extubation Prediction

Hospices Civils de Lyon92 enrolled

Overview

Successful weaning from mechanical ventilation in ICU patients depends on patient ability to breathe spontaneously and on cough efficiency. Previous studies found that cough peak flow (CPF) at 60 L/min threshold predicted extubation failure. These studies measured CPF using a dedicated flow-meter that required patient disconnection from the ventilator, limiting the generalizability of this procedure. This study aimed to predict extubation outcome in a consecutive series of patients by measuring CPF from the ventilator flow-meter. CPF measurements were done by freezing ventilator screen and scrolling the cursor to the maximal value of CPF during expiration and Tidal Volume (TV) in preceding inspiration. The objective was to assess the performance of CPF to predict early extubation outcome.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Extubation in ICU Patients

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age \> 18 years * Intubation \> 24h * Eligible for scheduled weaning trial and then scheduled extubation * Mechanical ventilation from Evita XL ventilator (Dräger, Germany) * Patient's agreement to participate Exclusion Criteria: \- Withdrawal decision of life supporting care

Locations (1)

Medical Intensive care unit, Croix-Rousse Hospital. 103 Grande Rue de la Croix-Rousse

Outcomes

Primary Outcomes

Early extubation success rate (EES rate)

Defining a relation between the CPF/TV ratio before extubation and early extubation success rate

Time frame: 48 hours

Secondary Outcomes

Scheduled weaning trial success rate

Defining a relation between the CPF/TV ratio before weaning trial and scheduled weaning trial success rate

Time frame: 48 hours