Clinical Application of Modified Burns Wean Assessment Program Scores at First Spontaneous Breathing Trial in Weaning Patients from Mechanical Ventilation
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Background: The purpose of this study was to evaluate the clinical application of modifiedBurns Wean Assessment Program (m-BWAP) scoring at first spontaneous breathing trial (SBT)as a predictor of successful liberation from mechanical ventilation (MV) in patients withendotracheal intubation. Methods: Patients requiring MV for more than 72 hours and undergoing more than one SBTin a medical intensive care unit (ICU) were prospectively enrolled over a 3-year period. Them-BWAP score at first SBT was obtained by a critical care nursing practitioner. Results: A total of 103 subjects were included in this study. Their median age was 69 years(range, 22 to 87 years) and 72 subjects (69.9%) were male. The median duration from admissionto first SBT was 5 days (range, 3 to 26 days), and the rate of final successful liberation fromMV was 84.5% (n=87). In the total group of patients, the successful liberation from MVgroup at first SBT (n=65) had significantly higher m-BWAP scores than did the unsuccessfulgroup (median, 60; range, 43 to 80 vs. median, 53; range, 33 to 70; P<0.001). Also, the areaunder the m-BWAP curve for predicting successful liberation of MV was 0.748 (95% confidenceinterval, 0.650 to 0.847), while the cutoff value based on Youden’s index was 53 (sensitivity,76%; specificity, 64%). Conclusions: The present data show that the m-BWAP score represents a good predictor ofweaning success in patients with an endotracheal tube in place at first SBT.
Abstract
Background: The purpose of this study was to evaluate the clinical application of modifiedBurns Wean Assessment Program (m-BWAP) scoring at first spontaneous breathing trial (SBT)as a predictor of successful liberation from mechanical ventilation (MV) in patients withendotracheal intubation. Methods: Patients requiring MV for more than 72 hours and undergoing more than one SBTin a medical intensive care unit (ICU) were prospectively enrolled over a 3-year period. Them-BWAP score at first SBT was obtained by a critical care nursing practitioner. Results: A total of 103 subjects were included in this study. Their median age was 69 years(range, 22 to 87 years) and 72 subjects (69.9%) were male. The median duration from admissionto first SBT was 5 days (range, 3 to 26 days), and the rate of final successful liberation fromMV was 84.5% (n=87). In the total group of patients, the successful liberation from MVgroup at first SBT (n=65) had significantly higher m-BWAP scores than did the unsuccessfulgroup (median, 60; range, 43 to 80 vs. median, 53; range, 33 to 70; P<0.001). Also, the areaunder the m-BWAP curve for predicting successful liberation of MV was 0.748 (95% confidenceinterval, 0.650 to 0.847), while the cutoff value based on Youden’s index was 53 (sensitivity,76%; specificity, 64%). Conclusions: The present data show that the m-BWAP score represents a good predictor ofweaning success in patients with an endotracheal tube in place at first SBT.
참고문헌 (26)
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