Evaluation of some predictors for successful weaning from mechanical ventilation

IntroductionMost international weaning researchers have attempted to find better indexes or parameters which can predict the weaning outcome in the best possible way.Our research attempts to confirm and find better weaning indexes and parameters.Aim of the workThe aim of this study is to compare between the efficacy of some predictors in different weaning modes for successful weaning from mechanical ventilation.MethodThe study was carried out on 100 (70 males, 30 females) patients receiving mechanical ventilation, due to respiratory and non respiratory causes. Patients were divided into 4 groups according to the method of weaning: group (1) CPAP (n = 25), group (2) PSV (n = 25), group (3) SIMV (n = 25) and group (4) NPPV (n = 25). We used a 3 step protocol for weaning according to Cleveland Clinical Journal of Medicine. The following assessments were carried out on admission, during MV (before weaning) and during weaning: PaCO2, pH, PaO2, RSBI (Rapid shallow breathing index), CROP index, The CORE index, integrative weaning index (IWI).ResultsThis study shows that the highest successes rate is in the NPPV group (92%) while the highest failure rate is in the SIMV group (36%). It also shows that there is non significant difference between the studied groups regarding PaO2, PaCo2 and PH before starting weaning (P value > .05). After starting weaning the highest value of PaO2, PaCO2, and PH was in the NIPPV group and the lowest value was in the SIMV group. There is highly significant difference (P value < 0.001) between patients who succeeded and who failed weaning as regards CORE index and only significant difference regarding RSBI, while there is non significant difference as regards other indices(CROP, IWI).ConclusionABG and RSBI can be used as good weaning predictors and the CORE index is better in predicting the weaning outcome than the CROP index, the IWI and the RSBI as their value is better in the NPPV group which expresses the highest success rate.