Escore visage, pressão inspiratória máxima e pico de fluxo de tosse apresentam excelente acurácia e sensibilidade para predizer a extubação de pacientes neurocríticos

Abstract

Objective: To evaluate predictive parameters of success in weaning from mechanical ventilation and extubation in patients with acute brain injury. Methods: This descriptive, analytical and inferential study was carried out with 64 neurocritical patients assisted at an intensive care unit. The patients, all with acute brain injury, were divided as to the success or failure of extubation. The assessments involved VISAGE score, analysis of maximum inspiratory and expiratory pressure, peak cough flow, airway occlusion pressure in 0.1 second and airway occlusion pressure relationship with maximum inspiratory pressure. Logistic regression tests were applied in order to measure the predictive factors linked to the success and failure of weaning and extubation of the patient. Statistical significance was set at 5%. Results: Patients with extubation failure had a longer hospital stay in intensive care than patients with success. Logistic regression analysis indicated that VISAGE score, maximum inspiratory pressure and peak cough flow are consistent factors in distinguishing success and failure from extubation in 74.30% of cases. The statistical model with these variables showed accuracy of 79.69% and sensitivity of 95.83%. Conclusion: VISAGE score, maximum inspiratory pressure and peak cough flow are highly accurate and sensitive in predicting success or failure of ventilatory weaning and extubation of the neurocritical patient. Research with other variables should be carried out with the aim of further expanding the accuracy of the success of ventilatory weaning and extubation.