Weaning Approach with Weaning Index for Postoperative Patients with Mechanical Ventilator Support in the ICU.

Chang,  Chul Ho; Hong,  Yong Woo; Koh,  Shin Ok

doi:2007.53.3.S47

Original Article

Korean Journal of Anesthesiology 2007;53(3):S47-S51.
DOI: https://doi.org/10.4097/kjae.2007.53.3.S47

Weaning Approach with Weaning Index for Postoperative Patients with Mechanical Ventilator Support in the ICU.

Chul Ho Chang, Yong Woo Hong, Shin Ok Koh

Department of Anesthesiology and Pain Medicine and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. sokoh@yumc.yonsei.ac.kr

Abstract

BACKGROUND
The weaning index is a useful tool for avoiding the detrimental consequences of weaning failure, rapidly identifying patients who are potentially ready for spontaneous breathing, and accelerating the process of liberation from mechanical ventilation. This study examined the use of the weaning index as a weaning and extubation predictor in postoperative patients on mechanical ventilatory support in an intensive care unit (ICU).
METHODS
Mechanical ventilation was discontinued in patients through pressure support ventilation (PSV), and a T-piece was applied to 169 patients. The success or failure of the weaning process was evaluated according to the preoperative conditions of the patient and their weaning indices, such as the rapid shallow breathing index (RSBI), vital capacity, inspiratory pressure. The duration of mechanical ventilation and the length of stay in the ICU and the hospital were recorded.
RESULTS
Weaning from mechanical ventilatory support and extubation was performed successfully in 94.6% of patients. Sixty minutes after applying the T-piece, the PaO2/FiO2 ratio (P/F ratio) was significantly higher and the RSBI was significantly lower in the weaning success group than in the weaning failure group. The ASA class and the percentage of emergency procedures were significantly lower (p < 0.05) in the weaning success group.
CONCLUSIONS
Not only the weaning index as RSBI but also P/F ratio, ASA class and emergency status need to be considered for successful weaning and extubation in postoperative ICU patients on mechanical ventilator support.

Key Words: mechanical ventilation; postoperative patients; rapid shallow breathing index; weaning and extubation predictor; weaning index