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Abstract: Slide Presentations |

COUGH STRENGTH AND MENTAL STATUS PREDICT EXTUBATION OUTCOMES FREE TO VIEW

Cong Y. Stonestreet, MD*; Lin Wang, MD; Svetlana Gutierrez, MD; Salam Raslan, MD; Jorge Gonzalez, MD; Gaffar Syed, MD; Nureain Mirza, MD; Yaw Amoateng-Adjepong, MD; Constantine A. Manthous, MD; Mihai Smina, MD
Author and Funding Information

Bridgeport Hospital & Yale University School of Medicine, Bridgeport, CT


Chest


Chest. 2005;128(4_MeetingAbstracts):195S-c-196S. doi:10.1378/chest.128.4_MeetingAbstracts.195S-c
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Abstract

PURPOSE:  To determine whether mental status (MS), cough peak flows (CPF) and endotracheal secretions (ES) affect extubation (EXT) outcomes.

METHODS:  We prospectively examined MS, CPF and ES of 86 patients recovering from respiratory failure who had passed a SBT.

RESULTS:  20 patients failed their initial EXT within 72 h. CPFs of failed patients was lower than successes (38±28 L/min vs. 65±33 L/min, p=0.002). Those with CPF<60 L/min were 4-times as likely to fail EXT compared to those with CPF 60 L/min or more (95% CI=1.3–12.9). Patients unable to complete any of 4 simple tasks (follow with eyes, open eyes, stick out tongue, grasp hand) were twice as likely to fail (95%CI=0.9-4.2). Those able to complete all 4 tasks but with CPF<60 L/min were twice as likely to fail (95%CI=1.4-2.7). Those with a required suctioning frequency of <2 h were twice as likely to fail (95%CI=1-5.3). These three “risk factors” (i.e. <4 tasks, <60 L/min, <2 h) were additive in predicting failure (see Figure).

CONCLUSION:  CPF, MS and ES contribute to EXT outcomes of patients who have passed a SBT.

CLINICAL IMPLICATIONS:  These quantifiable determinants of EXT outcome may be used to stratify pre-EXT risk of failure.  

DISCLOSURE:  Cong Stonestreet, None.

2:30 PM - 4:00 PM


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