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Development and validation of a clinical prediction model for early ventilator weaning in post-cardiac surgery.
Xie, Rong-Cheng; Wang, Yu-Ting; Lin, Xue-Feng; Lin, Xiao-Ming; Hong, Xiang-Yu; Zheng, Hong-Jun; Zhang, Lian-Fang; Huang, Ting; Ma, Jie-Fei.
Afiliación
  • Xie RC; Department of Critical Care Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, Fujian province, PR China.
  • Wang YT; Department of Critical Care Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, Fujian province, PR China.
  • Lin XF; Department of Critical Care Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, Fujian province, PR China.
  • Lin XM; Department of Critical Care Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, Fujian province, PR China.
  • Hong XY; Department of Critical Care Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, Fujian province, PR China.
  • Zheng HJ; Department of Critical Care Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, Fujian province, PR China.
  • Zhang LF; Department of Critical Care Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, Fujian province, PR China.
  • Huang T; Department of Critical Care Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, Fujian province, PR China.
  • Ma JF; Department of Critical Care Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen 361015, Fujian province, PR China.
Heliyon ; 10(7): e28141, 2024 Apr 15.
Article en En | MEDLINE | ID: mdl-38560197
ABSTRACT

Background:

Weaning patients from mechanical ventilation is a critical clinical challenge post cardiac surgery. The effective liberation of patients from the ventilator significantly improves their recovery and survival rates. This study aimed to develop and validate a clinical prediction model to evaluate the likelihood of successful extubation in post-cardiac surgery patients.

Method:

A predictive nomogram was constructed for extubation success in individual patients, and receiver operating characteristic (ROC) and calibration curves were generated to assess its predictive capability. The superior performance of the model was confirmed using Delong's test in the ROC analysis. A decision curve analysis (DCA) was conducted to evaluate the clinical utility of the nomogram.

Results:

Among 270 adults included in our study, 107 (28.84%) experienced delayed extubation. A predictive nomogram system was derived based on five identified risk factors, including the proportion of male patients, EuroSCORE II, operation time, pump time, bleeding during operation, and brain natriuretic peptide (BNP) level. Based on the predictive system, five independent predictors were used to construct a full nomogram. The area under the curve values of the nomogram were 0.880 and 0.753 for the training and validation cohorts, respectively. The DCA and clinical impact curves showed good clinical utility of this model.

Conclusion:

Delayed extubation and weaning failure, common and potentially hazardous complications following cardiac surgery, vary in timing based on factors such as sex, EuroSCORE II, pump duration, bleeding, and postoperative BNP reduction. The nomogram developed and validated in this study can accurately predict when extubation should occur in these patients. This tool is vital for assessing risks on an individual basis and making well-informed clinical decisions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Heliyon Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Heliyon Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido