Extubation failure: diagnostic value of occlusion pressure (P0.1) and P0.1-derived parameters.
OBJECTIVE
To evaluate the ability of the new, built-in occlusion pressure (P0.1) measurement to predict extubation failure.


METHODS
Prospective observational multicentre study in the ICU of five general hospitals.


METHODS
Hundred thirty patients on mechanical ventilation longer than 48 h when considered ready for weaning.


RESULTS
Patients underwent a 30-min spontaneous breathing trial with simultaneous monitoring of occlusion pressure (P0.1) and breathing pattern (f/Vt). Sixteen patients (12%) failed the weaning trial and full ventilatory support was resumed, while 114 tolerated the trial and were extubated. Twenty-one (18%) required reintubation within 48 h. The area under the ROC curve for diagnosing extubation failure was 0.53 for f/Vt, 0.59 for P0.1 and 0.61 for P0.1*f/Vt (p=NS). Accordingly, P0.1*f/Vt more than 100 detected extubation failure with a sensitivity of 0.89, specificity of 0.35, positive predictive value of 0.21 and negative predictive value of 0.94.


CONCLUSIONS
During a first trial of spontaneous breathing on pressure support ventilation (PSV), bedside P0.1 and P0.1*f/Vt are of little help, if any, for predicting extubation failure.
Fernandez
Rafael
R
Intensive Care Department, Hospital de Sabadell, Parc Tauli s/n, 08208, Sabadell, Barcelona, Spain. rfernandez@cspt.es.
Raurich
Juan Maria
JM
Intensive Care Department, Hospital Son Dureta, Andrea Doria 55, 07014, Palma de Mallorca, Spain.
Mut
Teresa
T
Intensive Care Department, Hospital General, Avenida Benicasim s/n, 12004, Castelló de la Plana, Spain.
Blanco
Jesus
J
Intensive Care Department, Hospital Río Hortega, Cardenal Torquemada s/n, 47010, Valladolid, Spain.
Santos
Antonio
A
Intensive Care Department, Complexo Hospitalario Universitario, Rua Ramon Baltar s/n, 15706, Santiago de Compostela, Spain.
Villagra
Ana
A
Intensive Care Department, Hospital de Sabadell, Parc Tauli s/n, 08208, Sabadell, Barcelona, Spain.
D000328:Adult; D000368:Aged; D001945:Breathing Exercises; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D011182:Postoperative Care / Q000534:rehabilitation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012120:Respiration Disorders / Q000534:rehabilitation / Q000628:therapy; D012121:Respiration, Artificial / Q000009:adverse effects*; D012128:Respiratory Distress Syndrome / Q000534:rehabilitation / Q000628:therapy; D012129:Respiratory Function Tests; D013997:Time Factors; D016896:Treatment Outcome; D015300:Ventilator Weaning