Background And Aims: The use of weaning predictive indicators can avoid early extubation and wrongful prolonged mechanical ventilation. This study aimed to determine the power of the integrative weaning index (IWI) in predicting the success rate of the spontaneous breathing trial (SBT) in patients under mechanical ventilation.
Materials And Methods: In this prospective study, 105 patients undergoing mechanical ventilation for over 48 h were enrolled. Before weaning initiation, the IWI was calculated and based on the defined cutoff point (≥25), the success rate of the SBT was predicted. In case of weaning from the device, 2-h SBT was performed and the physiologic and respiratory indices were continuously studied while being intubated. If they were in the normal range besides the patient's tolerance, the test was considered as a success. The result was then compared with the IWI and further analyzed.
Results: The SBT was successful in 90 (85.7%) and unsuccessful in 15 (14.3%) cases. The difference between the true patient outcome after SBT, and the IWI prediction was 0.143 according to the Kappa agreement coefficient ( < 0.001). Moreover, regarding the predictive power, IWI had high sensitivity (95.6%), specificity (40%), positive and negative predictive values (90.5% and 60), positive and negative likelihood ratios (1.59 and 0.11), and accuracy (86.7%).
Conclusion: The IWI as a more objective indicator has acceptable accuracy and power for predicting the 2-h SBT result. Therefore, in addition to the reliable prediction of the final weaning outcome, it has favorable power to predict if the patient is ready to breathe spontaneously as the first step to weaning.
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http://dx.doi.org/10.4103/ijccm.IJCCM_10_17 | DOI Listing |
J Formos Med Assoc
January 2025
School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan. Electronic address:
Background: Ethanol ablation (EA) has been proposed as a first-line treatment modality for recurrent symptomatic cystic thyroid nodules following initial aspiration. The efficacy of EA can be compromised when the initial nodule volume exceeds 10 mL. This study assessed the efficacy of single-session EA in managing thyroid cysts with an initial volume of ≥10 mL.
View Article and Find Full Text PDFMed Intensiva (Engl Ed)
January 2025
Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora, Brazil; School of Medicine, Federal University of Juiz de Fora, Minas Gerais, Brazil. Electronic address:
Objective: To evaluate the feasibility of adding mechanical insufflation-exsufflation (MI-E) to a weaning protocol for tracheostomized patients undergoing prolonged mechanical ventilation (MV).
Design: Single-center, open-label, randomized, controlled pilot and feasibility study.
Setting: Intensive care unit in Brazil.
Int Neurourol J
December 2024
Department of Urology, General Hospital of Southern Theater Command, Guangzhou, China.
Purpose: Precise electrode placement is crucial for the success of sacral neuromodulation (SNM). The aim of this study was to explore a more accurate and convenient method for positioning punctures during the first stage of SNM.
Methods: This retrospective study compared preoperative baseline values, intraoperative indicators, postoperative scores, and other clinical data from 130 patients who underwent SNM electrode implantation at our department between 2018 and 2023.
Int J Pediatr Otorhinolaryngol
January 2025
Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address:
Objectives: Surgery is the only treatment for congenital choanal atresia (CCA). It is crucial to avoid postoperative restenosis or re-occlusion of the neo-choana. This study investigated the efficacy of a navigation-assisted endoscopic endonasal U-flap technique and a bioabsorbable steroid-eluting stent for CCA repair.
View Article and Find Full Text PDFJ Cardiovasc Electrophysiol
January 2025
Cardiology Division, Geneva University Hospitals, Geneva, Switzerland.
Typical atrial flutter (AFL), defined as cavotricuspid isthmus (CTI)-dependent macro-re-entrant atrial tachycardia, often causes debilitating symptoms, and is associated with increased incidence of atrial fibrillation, stroke, heart failure, and death. Typical AFL occurs in patients with atrial remodeling and shares risk factors with atrial fibrillation. It is also common in patients with a history of prior heart surgery or catheter ablation.
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