RESUMEN
The purpose of this study was to determine the contributions of pulmonary mechanics, gas exchange, and hemodynamic function to prediction of success or failure with early weaning from mechanical ventilation after cardiac surgery. More than 40 physiologic measurements were determined on 162 patients at two time points in the early postoperative period: during full-support mechanical ventilation and during a trial of spontaneous ventilation. Discriminant analysis was used to analyze the differences between the success group (n = 134) and the failure group (n = 28) and to predict group membership of individual cases. A moderately strong relationship (canonical correlation = 0.733) was found between the groups and the discriminating variables. The discriminant function contained variables from all three dimensions of weaning criteria, with dimensions of hemodynamic function and pulmonary mechanics having greater import. The predictor set had a sensitivity of .98, specificity of .71, positive predictive value of .94, and negative predictive value of .87. Routine bedside measurements had a predictive performance equal or superior to variables previously studied.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos , Desconexión del Ventilador , Anciano , Femenino , Hemodinámica , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Valor Predictivo de las Pruebas , Intercambio Gaseoso Pulmonar , Factores de Tiempo , Capacidad VitalRESUMEN
The Society of Critical Care Medicine (SCCM) sponsored the Consensus Conference on Fostering More Human Care Creating a Healing Environment in October 1990 at Snowbird, Utah. The purpose of this conference was to address the challenges of providing sensitive, humane critical care in an increasingly technological and cost-conscious environment. The long-term objective was to develop this document (initially published by SCCM in 1992) as a resource for critical care professionals who are seeking methods by which to foster more humane care of their acutely ill patients.