From: Sex difference in the risk of extubation failure in ICUs
Extubation success (N = 546) | Reintubation at day 7 (N = 95) | P value* | |
---|---|---|---|
Characteristics of the patients at admission | |||
Sex male, n (%) | 354 (65%) | 71 (75%) | 0.059 |
Age, years | 70 ± 10 | 70 ± 8 | 0.599 |
Age > 65 years, n (%) | 389 (71%) | 71 (75%) | 0.485 |
Body-mass index, kg/m2 | 28 ± 7 | 27 ± 6 | 0.026 |
Body-mass index ≥ 30 kg/m2, n (%) | 182 (34%) | 24 (26%) | 0.107 |
SAPS II at admission, points | 55 ± 19 | 57 ± 18 | 0.381 |
Underlying chronic cardiac disease, n (%) | 266 (49%) | 40 (42%) | 0.233 |
Ischemic heart disease | 143 (26%) | 23 (24%) | 0.684 |
Atrial fibrillation | 90 (16%) | 13 (14%) | 0.492 |
Left ventricular dysfunction | 77 (14%) | 14 (15%) | 0.870 |
History of cardiogenic pulmonary edema | 39 (7%) | 7 (7%) | 0.937 |
Underlying chronic lung disease, n (%) | 181 (33) | 32 (34) | 0.918 |
Chronic obstructive pulmonary disease | 122 (22%) | 28 (29%) | 0.129 |
Obesity-hypoventilation syndrome | 46 (8%) | 3 (3%) | 0.074 |
Chronic restrictive pulmonary disease | 32 (6%) | 4 (4%) | 0.519 |
Main reason for admission | 0.042 | ||
Acute respiratory failure | 273 (50%) | 52 (55%) | 0.394 |
Coma | 96 (18%) | 16 (17%) | 0.860 |
Shock | 56 (10%) | 11 (12%) | 0.697 |
Cardiac arrest | 59 (11%) | 2 (2%) | 0.007 |
Surgery | 53 (10%) | 10 (11%) | 0.817 |
Other reason | 9 (2%) | 4 (4%) | 0.111 |
Characteristics of the patients on the day of extubation | |||
SOFA score, points | 4.2 ± 2.6 | 4.8 ± 2.8 | 0.027 |
Duration of mechanical ventilation, days | 5 [3–10] | 6 [3–10] | 0.316 |
Difficult or prolonged weaning #, n (%) | 176 (32%) | 30 (32%) | 0.970 |
Ineffective cough, n/n total (%) | 123 (24%) | 28 (30%) | 0.184 |
Abundant secretions, n/n total (%) | 194 (37%) | 41 (45%) | 0.178 |
Administration of steroids before extubation, n (%) | 86 (16%) | 9 (9%) | 0.112 |
Ventilator settings before the spontaneous breathing trial | |||
Pressure-support ventilation, n (%) | 467 (86%) | 81 (85%) | 0.945 |
Pressure-support level, cm H2O | 9 ± 3 | 10 ± 3 | 0.049 |
Positive end-expiratory pressure, cm H2O | 6 ± 2 | 6 ± 2 | 0.173 |
Respiratory rate, breaths/min | 22 ± 6 | 23 ± 7 | 0.089 |
Tidal volume, ml | 474 ± 136 | 475 ± 129 | 0.953 |
Tidal volume, ml/kg of predicted body weight | 7.8 ± 2.2 | 7. 5 ± 2.2 | 0.319 |
Rapid shallow breathing index: F/VT, breaths/min/l | 51 ± 23 | 55 ± 30 | 0.194 |
FiO2, % | 35 ± 10 | 35 ± 12 | 0.695 |
PaO2/FiO2, mm Hg | 275 ± 91 | 268 ± 91 | 0.446 |
pH, units | 7.45 ± 0.06 | 7.45 ± 0.06 | 0.999 |
PaCO2, mm Hg | 40 ± 8 | 39 ± 8 | 0.567 |
PaCO2 > 45 mm Hg, No. (%) | 101 (19%) | 21 (22%) | 0.443 |
Characteristics at the end of the spontaneous breathing trial | |||
Type of trial | |||
T-piece trial, n (%) | 336 (62%) | 58 (61%) | 0.928 |
Low level of pressure-support, n (%) | 210 (38%) | 37 (39%) | |
Median duration of the trial, min | 60 [30–60] | 45 [30–60] | 0.159 |
Respiratory support after extubation | |||
Prophylactic noninvasive ventilation, n (%) | 299 (55%) | 40 (42%) | 0.023 |
High-flow nasal oxygen, n (%) | 247 (45%) | 55 (58%) |