The predictive value of endotracheal tube cuff pressure change in the outcome of extubation in mechanically ventilated patients with AECOPD
10.3969/j.issn.1673-9701.2025.04.003
- VernacularTitle:气囊压力变化值在AECOPD机械通气患者拔管结局中的预测价值
- Author:
Min CHEN
1
;
Ting LENG
;
Xiahong HUANG
;
Xiaoli LIU
;
Ping JIA
;
Guoxue DU
;
Juan ZHANG
Author Information
1. 德阳市人民医院重症医学科,四川德阳 618000
- Publication Type:Journal Article
- Keywords:
Endotracheal tube cuff pressure change;
Acute exacerbation of chronic obstructive pulmonary diseas;
Mechanical ventilation;
Extubation;
Predictive value
- From:
China Modern Doctor
2025;63(4):11-15
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive value of endotracheal tube cuff pressure change(△Pcuff)on extubation outcome in mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary diseas(AECOPD).Methods A total of 93 AECOPD patients who underwent mechanical ventilation for at least 48 hours and required extubation through spontaneous breathing trial(SBT)from March 2023 to August 2024 in the Department of Critical Care Medicine of Deyang People's Hospital were selected as study subjects.According to the outcome of extubation,they were divided into successful extubation group and failed extubation group.General clinical data,laboratory results,△Pcuff at the start and at 30min of SBT were compared between two groups.Binary Logistic regression was used to analyze the risk factors affecting the outcome of extubation in AECOPD patients.The predictive value of △Pcuff for extubation outcome was evaluated by receiver operating characteristic(ROC)curve.Results Of the 93 patients,81 were successfully extubed and 12 were failed.Univariate analysis showed that △Pcuff(at the beginning of SBT),△Pcuff(SBT 30min),systolic blood pressure,pH,arterial partial pressure of oxygen,arterial partial pressure of carbon dioxide,and oxygenation index were all factors influencing the outcome of extubation(P＜0.05).Binary Logistic regression analysis showed that △Pcuff(at the beginning of SBT)was an independent risk factor for extubation outcome(P＜0.05).The ROC curve showed that △Pcuff(at the beginning of SBT)predicted extubation outcome with an area under the curve of 0.913,sensitivity of 84.0％,specificity of 83.3％,and Yoden index of 0.673,with an optimal cutoff of 34.5cmH2O(1cmH2O=0.098kPa).Conclusion The △Pcuff(at the beginning of SBT)has a good predictive value for the extubation outcome of mechanically ventilated patients with AECOPD,and the probability of successful extubation of a patient is higher when the △Pcuff is ≥34.5 cmH2O.
