SESSION TITLE: Respiratory Support Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM
PURPOSE: To compare serial CROP and serial RSBI in predicting weaning success of weaning patients from the ventilator.
METHODS: This is a prospective cohort study done in the Philippine Heart Center done from December 2011- November 2012. All patients aged >18 yo on mechanical ventilator for more than 48 hours and capable of being weaned. Serial RSBI and serial CROP was taken 30 minutes, 60 minutes and 120 minutes pre-extubation. ABG was taken at the end of each cycle. Extubation was a success if patient could sustain spontaneous breathing > 48 hours.
RESULTS: A total of 61 patients: 33(54.1%) males and 28(45.9%) females.The most common indication for intubation was ARF type I secondary to CHF(26%) and ARF type II secondary to AECOPD 16(26%). Longest duration on ventilator was 14 days mean 6+2.78. It was observed than an increasing trend of CROP predicted weaning success.Increasing values of RSBI was related to weaning failure. There were 6 patients who underwent facilitated extubation with NIV, their CROP scores were noted to be low.A cut off value of both parameters noted a sensitivity 78.6% and specificity 72.3% for CROP >16. RSBI value >52 had a 71.4% sensitivity and 70.2%specificity. Areas under the curve generated by ROC yielded 0.679+0.075 for RSBI and 0.735+0.087 for CROP.CROP having a greater value is more predictive, thus a better parameter.
CONCLUSIONS: Trends of weaning parameters can detect deteriorating pulmonary mechanics.An increasing trend of RSBI was noted in weaning failures. Conversely, an increasing pattern of CROP can predict weaning success.In this study, a CROP value>0.16 had a sensitivity of 78.6 and specificity of 72.3. RSBI value >52 had a 71.4 sensitivity and 70.2 specificity. CROP index having a higher sensitivity and specificity than RSBI makes a better predictor foe weaning success..
CLINICAL IMPLICATIONS: Failure of extubation is more likely if there is an increasing pattern of RSBI even if it is <105.A low CROP score in prolonged intubated patients, facilitated extubation with NIV should be done to prevent reintubation. .
DISCLOSURE: The following authors have nothing to disclose: Angelene Taleon-Parazo, Lucas Uy
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