title: Weaning predictors do not predict extubation failure in simple-to-wean patients.
abstract: BACKGROUND
  Predictor indexes are often included in weaning protocols and may help the intensive care unit (ICU) staff to reach expected weaning outcome in patients on mechanical ventilation.
  
  
  OBJECTIVE
  The objective of this study is to evaluate the potential of weaning predictors during extubation.
  
  
  METHODS
  This is a prospective clinical study.
  
  
  METHODS
  The study was conducted in 3 medical-surgical ICUs.
  
  
  METHODS
  Five hundred consecutive unselected patients ventilated for more than 48 hours were included.
  
  
  METHODS
  All patients were extubated after 30 minutes of successful spontaneous breathing trial and followed up for 48 hours. The protocol evaluated hemodynamics, ventilation parameters, arterial blood gases, and the weaning indexes frequency to tidal volume ratio; compliance, respiratory rate, oxygenation, and pressure; maximal inspiratory pressure; maximal expiratory pressure; Pao(2)/fraction of inspired oxygen; respiratory frequency; and tidal volume during mechanical ventilation and in the 1st and 30th minute of spontaneous breathing trial.
  
  
  RESULTS
  Reintubation rate was 22.8%, and intensive care mortality was higher in the reintubation group (10% vs 31%; P < .0001). The areas under the receiver operating characteristic curve showed that tests did not discriminate which patients could tolerate extubation.
  
  
  CONCLUSIONS
  Usual weaning indexes are poor predictors for extubation outcome in the overall ICU population.
authors.affiliation: Intensive Care Unit of Moinhos de Vento Hospital, Porto Alegre, Rua Ramiro Barcelos 910, Brazil. gutosavi@bol.com.br
authors.forename: Augusto
authors.initials: A
authors.lastname: Savi
authors.forename: Cassiano
authors.initials: C
authors.lastname: Teixeira
authors.forename: Joyce Michele
authors.initials: JM
authors.lastname: Silva
authors.forename: Luis Guilherme
authors.initials: LG
authors.lastname: Borges
authors.forename: Priscila Alves
authors.initials: PA
authors.lastname: Pereira
authors.forename: Kamile Borba
authors.initials: KB
authors.lastname: Pinto
authors.forename: Fernanda
authors.initials: F
authors.lastname: Gehm
authors.forename: Fernanda Callefe
authors.initials: FC
authors.lastname: Moreira
authors.forename: Ricardo
authors.initials: R
authors.lastname: Wickert
authors.forename: Cristiane Brenner Eilert
authors.initials: CB
authors.lastname: Trevisan
authors.forename: Juçara Gasparetto
authors.initials: JG
authors.lastname: Maccari
authors.forename: Roselaine Pinheiro
authors.initials: RP
authors.lastname: Oliveira
authors.forename: Silvia Regina Rios
authors.initials: SR
authors.lastname: Vieira
mesh_terms: D000328:Adult; D000368:Aged; D060666:Airway Extubation; D002985:Clinical Protocols; D016638:Critical Illness; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017211:Treatment Failure; D015300:Ventilator Weaning