The predictive value of electrical impedance tomography for extubation failure in critically ill patients
10.3760/cma.j.issn.1671-0282.2024.12.014
- VernacularTitle:肺电阻抗断层成像对重症患者拔管失败的预测价值
- Author:
Wei DA
1
;
MingYue NIU
;
Tiantian ZHU
;
Xiaobo WANG
;
Peipei LIANG
;
Xiaodong XIE
;
Rui CHEN
;
Ran LI
;
Zhenxing DING
;
Hong ZHANG
Author Information
1. 安徽医科大学第一附属医院急诊医学科，合肥 230032
- Keywords:
Mechanical ventilation;
Extubation failure;
Electrical impedance tomography;
spontaneous breathing trial
- From:
Chinese Journal of Emergency Medicine
2024;33(12):1743-1747
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the changes in electrical impedance tomography (EIT) during the extubation phase in critically ill patients undergoing invasive mechanical ventilation (MV),and evaluate the value of EIT and EAdi in predicting extubation failure in critically ill patients.Methods:The clinical data of patients undergoing invasive mechanical ventilation and SBT in the emergency intensive care unit (EICU) of the First Affiliated Hospital of Anhui Medical University from January 2022 to June 2024 were prospectively collected. The values of EIT were monitored and recorded at pressure support ventilation, 2 hours after extubation and 6 hours after extubation. According to whether the patient was re-intubated within 48 hours after extubation,patients were divided into successful extubation group and extubation failure group. The values of EIT were compared at the same time point between the two groups, and the correlation analysis of the values of EIT was carried out. The ROC curve was used to analyze the predictive ability of EIT at pressure support ventilation, 2 hours after extubation and 6 hours after extubation after SBT passage for extubation failure.Results:A total of 110 patients were included in the study, of which 52 patients failed to extubation. Patients in the failed extubation group had a smaller available ventilation area (SAV) before and after extubation compared to those in the successful extubation group, and had a higher Global Inhomogeneity Index (GI) ( P<0.001). The regional ventilation delay and the the center of ventilation were not different between groups. Conclusions:The values of EIT are valid predictors of extubation failure in critically ill patients and are suitable for clinical application.
