Taxa de Sucesso do Desmame Ventilatório de Pacientes Mecanicamente Ventilados: Estudo de Demanda para Indicador de Qualidade de uma UTI de Hospital Público de Campo Grande, MS

2019 ◽  
Vol 22 (2) ◽  
pp. 97
Author(s):  
Clara Helen Oliveira Bezerra ◽  
Daniel Martins Pereirab
Keyword(s):  
Mechanical Ventilation ◽  
Success Rate ◽  
Quality Indicators ◽  
Quality Indicator ◽  
Extubation Failure ◽  
Failure Group ◽  
Ventilation Weaning ◽  
Success Group ◽  
The Mean ◽  
Mechanical Ventilation Weaning

O desmame ventilatório é o processo de descontinuação da ventilação mecânica invasiva - VMI e retirada da prótese endotraqueal, quando opaciente está apto a retornar para a ventilação espontânea. A mensuração da taxa do sucesso do desmame ventilatório oferece dados quantificáveis referentes ao desfecho da interrupção da VMI, podendo este ser utilizado para a criação de um indicador de qualidade. Indicadores de qualidade são medidas utilizadas para descrever uma situação existente e são ferramentas importantes para avaliar o desempenho e realizar planejamentos. Objetiva-se mensurar a taxa de sucesso e insucesso da extubação, identificando o processo do desmame ventilatório e coletando informações para a elaboração de um indicador de qualidade do serviço de fisioterapia. Tratou-se de um estudo clínico prospectivo observacional, com coleta de dados de pacientes internados na UTI, sob VMI aptos à realização do teste de respiração espontânea - TRE. Após a extubação, o participante foi incluído no grupo sucesso ou no grupo falha da extubação. Foram incluídos 50 participantes sob VMI aptos a realização do teste de respiração espontânea, seguido da extubação. Destes, 29(58%) eram do sexo masculino e 21(42%) do sexo feminino. A média de idade foi de 59,0±17,9 anos. A taxa de sucesso da extubação foi de 86%(43). Conclui-se que para a amostra estudada, considerando suas características, a taxa de sucesso da extubação se aproxima das descritas na literatura. Porém, esta taxa não se mostrou adequada para compor um indicador de qualidade do serviço de fisioterapia.Palavras-chave: Indicadores de Qualidade. Desmame do Respirador Mecânico. Extubação.Abstractventilatory weaning is the weaning process of mechanical ventilation and removal of the endotracheal prosthesis when the patient is ableto return to spontaneous ventilation. The measurement of the success rate of ventilatory weaning provides quantifiable data regarding theoutcome of the IMV interruption, which can be used to create a quality indicator. Quality indicators are measures used to describe an existingsituation and are important tools for evaluating performance and planning. to measure the success rate and failure of extubation, identifying the ventilatory weaning process and collecting information for the elaboration of a quality indicator of the physiotherapy service. it wasa prospective observational clinical study with data collection of patients in an intensive care unit in IMV able to undergo to spontaneousbreathing trial (SBT). After extubation, the participant was included in the success group or in the extubation failure group. Fifty participantsin IMV were eligible to perform the spontaneous breathing test and extubation. Of these 29 (58%) were male and 21 (42%) were female. The mean age was 59.0 ± 17.9 years. The success rate of extubation was 86% (43). it is concluded that for the studied sample, considering its characteristics, the success rate of extubation is close to those described in the literature. However, this rate was not adequate to compose a quality indicator of the physiotherapy service.Keywords: Quality Indicators. Mechanical Ventilation Weaning. Extubation.

scholarly journals Faktor-Faktor yang Berhubungan dengan Pengetahuan Perawat Tentang Penyapihan Ventilasi Mekanik Di Ruang Perawatan Intensif Rumah Sakit Panti Rapih Yogyakarta

2021 ◽  
Vol 2 (2) ◽  
pp. 103-115
Author(s):  
Ganes Irawati Hardjono ◽  
Chatarina Setya Widyastuti ◽  
Fransisca Anjar Rina
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
P Value ◽  
Sources Of Information ◽  
Cross Sectional ◽  
Collaborative Action ◽  
Ventilation Weaning ◽  
Level Of Knowledge ◽  
The Mean ◽  
Mechanical Ventilation Weaning

Background: Mechanical ventilation weaningis a collaborative action of multidisciplines. The nurse's knowledge plays an important role in assessing the readiness of the patient and observing it during the weaning process to support the success of the patient escaping from mechanical ventilation.   Objective: The purpose of this study was to determine the factors related to the knowledge of nurses about mechanical ventilation weaning in the Intensive Care Room at Panti Rapih Hospital.   Methods:This research is adescriptive analytic study with a cross sectional approach. The population of this study were all nurses who worked in the Intensive Care Room at Panti Rapih Hospital, Yogyakarta. The sample in this study was the total population, namely nurses in the Intensive Care Room, amounting to 48 respondents. The research instrument was avalid and reliable questionnaire on the level of knpwledge and influencing factors with a calculated r value of morethan 0.482 and cronbach alpha 0.75. Analysis using independent T-test and Spearman   Results: The mean level of knowledge of respondents about mechanical ventilation weaning averaged 31.52 with CI7.458. Factors related to mechanical ventilation weaning knowledgein this studywereage (p-value:0.024), education (p-value:0.000), experience (p-value: 0.003), social and cultural (p-value: 0.009).), and sources of information (p-value:0.001). Meanwhile, the factors that were not related to knowledge of mechanical ventilation in this study were environment (p-value:0.115) and economy (p-value:0.231).

scholarly journals Mechanical ventilation weaning issues can be counted on the fingers of just one hand: part 2

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Luigi Vetrugno ◽  
Alessandro Brussa ◽  
Giovanni Maria Guadagnin ◽  
Daniele Orso ◽  
Francesco De Lorenzo ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Hand Part ◽  
Ventilation Weaning ◽  
Mechanical Ventilation Weaning

Validation of Psoas Muscle Index as a predictor of successful extubation in elderly intensive care patients: a retrospective cohort study

2020 ◽  
Author(s):  
Fumimasa Kobori ◽  
Kazunari Azuma ◽  
Shiro Mishima ◽  
Jun Oda
Keyword(s):  
Intensive Care ◽  
Psoas Muscle ◽  
Extubation Failure ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Predictive Values ◽  
Failure Group ◽  
Success Group ◽  
Sensitivity Specificity

Abstract Background Extubation failure-associated factors haven't been investigated in elderly patients. We hypothesized that psoas cross-sectional area, an emerging indicator of frailty, can be a predictor of extubation outcomes. Methods This retrospective study analyzed data from patients admitted between January and April 2016 at the intensive care unit (ICU) of the Tokyo Medical University Hospital. Patients were considered eligible if aged ≥65 years, required intubation at the emergency room, and were admitted to ICU for <24 h. Overall, 39 ICU patients were eligible and categorized into two groups: extubation success (n = 24) and extubation failure (n = 15) groups. The psoas cross-sectional area was measured at the third lumbar level on computer tomography images. Regions of interest were drawn freehand to outline the left and right psoas by an emergency physician. The average left and right psoas cross-sectional areas, used as the patient’s psoas cross-sectional area, were calculated. Psoas Muscle Index (PMI) was defined as the psoas cross-sectional area/height 2 . Primary outcome was to evaluate differences between the psoas cross-sectional area and f(PMI) between the groups, if any. Secondary outcome was to derive cut-off values using ROC curves. Results Both groups were comparable in terms of demographic characteristics. Psoas cross-sectional area (success group, 1776.5 ± 498.2 mm 2 , failure group, 1391.2 ± 589.4 mm 2 ; p = 0.022) and PMI (success group, 1089 ± 270.7 mm 2 /m 2 , failure group, 889 ± 338.5 mm 2 /m 2 ; p = 0.032) were significantly greater in the success group than in the failure group. ROC curve of the psoas cross-sectional area and PMI were used to calculate sensitivity and specificity. ROC AUC was 0.74 for psoas cross-sectional area, and at a cut-off of 1260 points, the sensitivity, specificity, and positive and negative predictive values were 95.8%, 60.0%, 79.3%, and 90.0%, respectively. ROC AUC for PMI was 0.73, and at a cut-off of 812 points, the sensitivity, specificity, and positive and negative predictive values were 95.8%, 46.7%, 74.2%, and 87.5%, respectively. Conclusions The psoas cross-sectional area and PMI can predict extubation outcomes in elderly intensive care patients.

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