The predictive value of different index on COPD patients in weaning process

Abstract

Objective To compare the predictive effect of different index on chronic obstructive pulmonary disease (COPD) patients in weaning process.Methods Seventeen patients with COPD after mechanical ventilation for at least 48 hours who were ready for weaning were enrolled.All patient accepted 2 hours spontaneous breathing trial under the T-piece.The airway occlusion pressure (P0.1),maximal inspiratory pressure (Pimax) and rapid shallow breathing index (RSBI) were detected at 30 minutes after spontaneous breathing trial.The clinical value of P0.1,Pimax and RSBI index for prognosis of successful weaning from COPD patients were assessed.Results Ten patients were successfully weaned from ventilation,and seven patients were difficulty weaned from ventilation.P0.1 and RSBI in weaning success group were lower than those in weaning failure group (P ＜0.05).Pimax in weaning success group was higher than that in weaning failure group (P ＜0.05).P0.1 was superior to RSBI and Pimax in predicting weaning outcomes from COPD patients,which sensitivity was 89％,the specificity was 75％,and the accuracy was 82％.They were higher than those of Pimax and RSBI.Conclusions The RSBI,P＜1 and Pimax are valuable predictor for the patients with COPD to wean from mechanical ventilation,and the predicting value of P0.1 is the biggest. Key words: Spontaneous breathing trial; Airway occlusion pressure; Maximal inspiratory pressure; Rapid shallow breathing index