Inspiratory pressure/maximal inspiratory pressure: Does it predict successful extubation in critically ill infants and children?

M. F. El-Khatib, B. Baumeister, P. G. Smith, R. L. Chatburn, J. L. Blumer

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Objective: To evaluate the accuracy of the initial negative inspiratory pressure (PI) to maximal negative inspiratory pressure (PI(max)) ratio in predicting extubation outcome for intubated infants and children. Design: A prospective study. Setting. Pediatric intensive care unit. Patients: A sample of 50 stable intubated pediatric patients who were judged clinically ready for extubation. Methods: Using a one-way valve, PI and PI(max) were measured in all patients, after which the ≤ ratio PI/PI(max) was calculated and its accuracy in predicting extubation outcome evaluated. Measurements and results. A total of 39 patients (78%) were successfully extubated and 11 patients (22%) were not. The mean PI/PI(max) ratio was not significantly different between extubation successes (0.36 ± 0.14) and failures (0.45 ± 0.1) (P > 0.05). The cut-off value of 0.3 for PI/PI(max) identified in adult patients did not discriminate between extubation success and failure in children. Furthermore, a discriminatory cut-off value other than 0.3 could not be identified for infants and children. Conclusion: The PI/PI(max) ratio cannot be used to predict extubation outcome in pediatric patients. Indices that predict extubation outcome in adults should not be extrapolated to infants and children before testing and validation.

Original languageEnglish
Pages (from-to)264-268
Number of pages5
JournalIntensive Care Medicine
Volume22
Issue number3
DOIs
StatePublished - 1996

Keywords

  • Extubation outcome
  • Intensive care unit
  • Mechanical ventilation
  • Pediatrics
  • Pressure ratio

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