Abstract
Weaning from mechanical ventilation remains a major challenge for critical care physicians. Because subjective criteria are inaccurate, objective measurements consisting of clinical criteria and physiologic tests (weaning predictors) have been used to facilitate decision-making. An integrated weaning index calculated as the product of static compliance and arterial oxygen saturation divided by the frequency-tidal volume ratio appears to be more accurate than other currently available predictors. Despite the accuracy of this new test, a beneficial effect on outcome is yet to be proven.
Highlights
Invasive mechanical ventilation provides support during recovery from acute respiratory failure but results in complications, and longer duration of intubation is associated with increased mortality
The integrative weaning index (IWI) is calculated as the product of static compliance and arterial oxygen saturation divided by the frequency to tidal volume ratio (f/VT)
Receiver operator characteristic analysis showed the IWI to be more accurate than the frequency, the tidal volume, the f/VT, the static compliance of the respiratory system, PaO2/FiO2, the airway occlusion pressure, and the airway occlusion pressure × f/VT product
Summary
Invasive mechanical ventilation provides support during recovery from acute respiratory failure but results in complications, and longer duration of intubation is associated with increased mortality. The respiratory frequency to tidal volume ratio (f/VT) appears to be most accurate [3]. Receiver operator characteristic analysis showed the IWI to be more accurate than the frequency, the tidal volume, the f/VT, the static compliance of the respiratory system, PaO2/FiO2, the airway occlusion pressure, and the airway occlusion pressure × f/VT product.
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