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Date Published: 25/06/2024
Online Published: 25/06/2024
Abstract Views: 92
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DOI: https://doi.org/10.58490/ctump.2024i75.2592
Issue
No. 75 (2024)
Section
Article
How to Cite
Vo, T. T. H., Vo, M. P., & Ha, T. D. (2024). WEANING OUTCOMES AND PREDICTORS OF SUCCESSFUL VENTILATOR WEANING IN STROKE PATIENTS REQUIRING INVASIVE VENTILATION. Cantho Journal of Medicine and Pharmacy, 75, 129-135. https://doi.org/10.58490/ctump.2024i75.2592

WEANING OUTCOMES AND PREDICTORS OF SUCCESSFUL VENTILATOR WEANING IN STROKE PATIENTS REQUIRING INVASIVE VENTILATION

Thi Thuy Hien Vo1,, Minh Phuong Vo1, Tan Duc Ha2
1 Can Tho University of Medicine and Pharmacy
2 Can Tho Central General Hospital

Main Article Content

Abstract

Background: From what has been recorded in the medical literature and in a number of studies, the majority of stroke patients who are receiving mechanical ventilation have a poor prognosis due to issues linked with the ventilator. As a result of these difficulties, the patient can sustain secondary brain damage, which would make their initial stroke state much worse. It is for this reason that weaning stroke patients out of artificial ventilation is a considerable problem in neuro-intensive care units. Objectives: To determine the rate of successful ventilator weaning as well as the factors that predict successful weaning from the ventilator. Materials and methods: A prospective study was conducted on 76 stroke patients who were receiving invasive ventilation at Can Tho Central General Hospital from February 2023 to  January 2024. Results: The success rate of weaning was 26.3%, and the mortality rate was 13.1%. Six factors were associated with successful weaning outcomes: respiratory rate before the spontaneous breathing trial (SBT) (OR: 25), minute ventilation (MV) before SBT (OR: 9), FiO2 before SBT (OR: 1.1), systolic blood pressure (SBP) after SBT (OR: 1.1), rapid shallow breathing index (RSBI) after SBT (OR: 1.8), and SpO2 after SBT (OR: 1.2); all with p<0,05. Among these, SpO2 after SBT was a significant prognostic factor for successful weaning in stroke patients on mechanical ventilation, with an area under the curve (AUC) of 0.906 (p<0.001; 95% CI: 0.8-1.0). The optimal cutoff point for SpO2 after SBT was 95.5%, with a sensitivity of 90%, specificity of 80%, positive predictive value of 70%, and negative predictive value of 92.9%. Conclusion: The percentage of stroke patients who are able to successfully wean themselves off of artificial ventilation is relatively low. On the other hand, SpO2 following the SBT is an important prognostic factor for effectively weaning these patients off their medications. 

Article Details

Keywords

Stroke patients, mechanical ventilation, successful predictors, weaning

References

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