Extubation failure predictors in the release process of invasive mechanical ventilatory support in pediatrics
Invasive mechanical ventilation (IMV) in pediatric intensive care units (PICUs) is a ubiquitous practice; the weaning process is supported by predictors, none of which guarantees success. Objectives: To describe the weaning process from IMV and to determine the predictive factors of extubation failu...
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| Autores principales: | , , , , , , , , , , , , , , |
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| Formato: | Artículo revista |
| Lenguaje: | Español |
| Publicado: |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2025
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| Materias: | |
| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/46292 |
| Aporte de: |
| id |
I10-R327-article-46292 |
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| record_format |
ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
pediatric intensive care unit mechanical ventilation tracheal extubation risk factors unidad de cuidados intensivos pediátrica ventilación mecánica extubación traqueal factores de riesgo unidades de terapia intensiva pediátrica respiração artificial extubação fatores de risco |
| spellingShingle |
pediatric intensive care unit mechanical ventilation tracheal extubation risk factors unidad de cuidados intensivos pediátrica ventilación mecánica extubación traqueal factores de riesgo unidades de terapia intensiva pediátrica respiração artificial extubação fatores de risco Palmeiro, Jorge Taffarel, Pedro Nociti, Yamila Laulhé, Verónica Giménez, Laura Lamberti, Laura Doi , Paula Erviti , Marina Fassola , Juliana Lisciotto , Lourdes López Cottet , Soledad Dos Santos, Monica Meregalli , Claudia Jorro Barón , Facundo Palmeiro, Jorge Taffarel, Pedro Nociti, Yamila Laulhé, Verónica Giménez, Laura Lamberti, Laura Doi , Paula Erviti , Marina Fassola , Juliana Lisciotto , Lourdes López Cottet , Soledad Dos Santos, Monica Meregalli , Claudia Jorro Barón , Facundo Palmeiro, Jorge Taffarel, Pedro Yamila Laulhé, Verónica Giménez, Laura Lamberti, Laura Doi , Paula Erviti , Marina Fassola , Juliana Lisciotto , Lourdes López Cottet , Soledad Dos Santos, Monica Meregalli , Claudia Jorro Barón , Facundo Extubation failure predictors in the release process of invasive mechanical ventilatory support in pediatrics |
| topic_facet |
pediatric intensive care unit mechanical ventilation tracheal extubation risk factors unidad de cuidados intensivos pediátrica ventilación mecánica extubación traqueal factores de riesgo unidades de terapia intensiva pediátrica respiração artificial extubação fatores de risco |
| author |
Palmeiro, Jorge Taffarel, Pedro Nociti, Yamila Laulhé, Verónica Giménez, Laura Lamberti, Laura Doi , Paula Erviti , Marina Fassola , Juliana Lisciotto , Lourdes López Cottet , Soledad Dos Santos, Monica Meregalli , Claudia Jorro Barón , Facundo Palmeiro, Jorge Taffarel, Pedro Nociti, Yamila Laulhé, Verónica Giménez, Laura Lamberti, Laura Doi , Paula Erviti , Marina Fassola , Juliana Lisciotto , Lourdes López Cottet , Soledad Dos Santos, Monica Meregalli , Claudia Jorro Barón , Facundo Palmeiro, Jorge Taffarel, Pedro Yamila Laulhé, Verónica Giménez, Laura Lamberti, Laura Doi , Paula Erviti , Marina Fassola , Juliana Lisciotto , Lourdes López Cottet , Soledad Dos Santos, Monica Meregalli , Claudia Jorro Barón , Facundo |
| author_facet |
Palmeiro, Jorge Taffarel, Pedro Nociti, Yamila Laulhé, Verónica Giménez, Laura Lamberti, Laura Doi , Paula Erviti , Marina Fassola , Juliana Lisciotto , Lourdes López Cottet , Soledad Dos Santos, Monica Meregalli , Claudia Jorro Barón , Facundo Palmeiro, Jorge Taffarel, Pedro Nociti, Yamila Laulhé, Verónica Giménez, Laura Lamberti, Laura Doi , Paula Erviti , Marina Fassola , Juliana Lisciotto , Lourdes López Cottet , Soledad Dos Santos, Monica Meregalli , Claudia Jorro Barón , Facundo Palmeiro, Jorge Taffarel, Pedro Yamila Laulhé, Verónica Giménez, Laura Lamberti, Laura Doi , Paula Erviti , Marina Fassola , Juliana Lisciotto , Lourdes López Cottet , Soledad Dos Santos, Monica Meregalli , Claudia Jorro Barón , Facundo |
| author_sort |
Palmeiro, Jorge |
| title |
Extubation failure predictors in the release process of invasive mechanical ventilatory support in pediatrics |
| title_short |
Extubation failure predictors in the release process of invasive mechanical ventilatory support in pediatrics |
| title_full |
Extubation failure predictors in the release process of invasive mechanical ventilatory support in pediatrics |
| title_fullStr |
Extubation failure predictors in the release process of invasive mechanical ventilatory support in pediatrics |
| title_full_unstemmed |
Extubation failure predictors in the release process of invasive mechanical ventilatory support in pediatrics |
| title_sort |
extubation failure predictors in the release process of invasive mechanical ventilatory support in pediatrics |
| description |
Invasive mechanical ventilation (IMV) in pediatric intensive care units (PICUs) is a ubiquitous practice; the weaning process is supported by predictors, none of which guarantees success.
Objectives: To describe the weaning process from IMV and to determine the predictive factors of extubation failure (EF).
Patients and Methods: Retrospective study, patients with more than 48 h of IMV, period 11/2019 to 10/2023. The following were excluded: deceased, referred to another institution and tracheostomized patients. Demographic characteristics, ventilatory status prior to extubation (IMV and blood gas parameters), variables related to the spontaneous breathing test and post-extubation support [noninvasive ventilation (NIV)] of successful vs failed extubation groups were compared aimed at determining the existence of predictors.
Results: 510 extubation events were recorded in 445 patients, with an EF rate of 12.7%. Admission for respiratory reasons (92 vs 78%), higher respiratory rate (22 vs 20 per minute) and fraction of inspired O2 (0.32 vs 0.4) programmed on the ventilator, and use of post-extubation NIV (51 vs 24%) were significantly associated with EF. In multivariate analysis, this association persisted for higher expiratory tidal volume prior to extubation and the use of NIV post-extubation. EF resulted in more days in IMV (10 vs 7) and PICU (13 vs 9).
Conclusion: Higher exhaled tidal volume prior to extubation and use of NIV post-extubation were predictive factors of EF, this being associated with longer stay in IMV. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2025 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/46292 |
| work_keys_str_mv |
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2025-10-10T05:05:50Z |
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2025-11-27T05:07:51Z |
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1849918825336668160 |
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I10-R327-article-462922025-11-12T21:08:55Z Extubation failure predictors in the release process of invasive mechanical ventilatory support in pediatrics Predictores de falla de extubación en el proceso de liberación de la asistencia ventilatoria mecánica invasiva en pediatría Preditores de falha de extubação no processo de liberação de assistência ventilatória mecânica invasiva em pediatria Palmeiro, Jorge Taffarel, Pedro Nociti, Yamila Laulhé, Verónica Giménez, Laura Lamberti, Laura Doi , Paula Erviti , Marina Fassola , Juliana Lisciotto , Lourdes López Cottet , Soledad Dos Santos, Monica Meregalli , Claudia Jorro Barón , Facundo Palmeiro, Jorge Taffarel, Pedro Nociti, Yamila Laulhé, Verónica Giménez, Laura Lamberti, Laura Doi , Paula Erviti , Marina Fassola , Juliana Lisciotto , Lourdes López Cottet , Soledad Dos Santos, Monica Meregalli , Claudia Jorro Barón , Facundo Palmeiro, Jorge Taffarel, Pedro Yamila Laulhé, Verónica Giménez, Laura Lamberti, Laura Doi , Paula Erviti , Marina Fassola , Juliana Lisciotto , Lourdes López Cottet , Soledad Dos Santos, Monica Meregalli , Claudia Jorro Barón , Facundo pediatric intensive care unit mechanical ventilation tracheal extubation risk factors unidad de cuidados intensivos pediátrica ventilación mecánica extubación traqueal factores de riesgo unidades de terapia intensiva pediátrica respiração artificial extubação fatores de risco Invasive mechanical ventilation (IMV) in pediatric intensive care units (PICUs) is a ubiquitous practice; the weaning process is supported by predictors, none of which guarantees success. Objectives: To describe the weaning process from IMV and to determine the predictive factors of extubation failure (EF). Patients and Methods: Retrospective study, patients with more than 48 h of IMV, period 11/2019 to 10/2023. The following were excluded: deceased, referred to another institution and tracheostomized patients. Demographic characteristics, ventilatory status prior to extubation (IMV and blood gas parameters), variables related to the spontaneous breathing test and post-extubation support [noninvasive ventilation (NIV)] of successful vs failed extubation groups were compared aimed at determining the existence of predictors. Results: 510 extubation events were recorded in 445 patients, with an EF rate of 12.7%. Admission for respiratory reasons (92 vs 78%), higher respiratory rate (22 vs 20 per minute) and fraction of inspired O2 (0.32 vs 0.4) programmed on the ventilator, and use of post-extubation NIV (51 vs 24%) were significantly associated with EF. In multivariate analysis, this association persisted for higher expiratory tidal volume prior to extubation and the use of NIV post-extubation. EF resulted in more days in IMV (10 vs 7) and PICU (13 vs 9). Conclusion: Higher exhaled tidal volume prior to extubation and use of NIV post-extubation were predictive factors of EF, this being associated with longer stay in IMV. La asistencia ventilatoria mecánica invasiva (AVMi) en unidades de terapia intensiva pediátrica (UCIP) es una práctica omnipresente, su liberación se respalda en predictores, no existiendo alguno que garantice el éxito. Objetivos: Describir el proceso de liberación de la AVMi y determinar los factores predictores de fracaso de extubación (FE). Pacientes y Métodos: Estudio retrospectivo, pacientes con más de 48 h de AVMi, periodo 11/2019 al 10/2023. Se excluyeron: fallecidos, derivados a otra institución y traqueostomizados. Se compararon las características demográficas, el estado ventilatorio previo a la extubación (parámetros de AVMi y gasometría), las variables relacionadas con la prueba de ventilación espontánea y con el soporte posextubación [ventilación no invasiva (VNI)] de los grupos éxito vs fracaso de extubación, tendiente a determinar la existencia de predictores. Resultados: Se registraron 510 eventos de extubación en 445 pacientes, siendo el FE del 12,7 %. Se asociaron en forma significativa con FE: ingreso por causa respiratoria (92 vs 78 %), mayor frecuencia respiratoria (22 vs 20 por minuto) y fracción inspirada de O2 (0,32 vs 0,4) programadas en el ventilador y utilización de VNI posextubación (51 vs 24 %). En el análisis multivariado esta asociación persistió para mayor volumen tidal espirado previo a la extubacion y uso de VNI posextubación. El FE redundó en más días en AVMi (10 vs 7) y en UCIP (13 vs 9). Conclusión: El mayor volumen tidal espirado previo a la extubacion y uso de VNI posextubación fueron factores predictores de FE, asociándose éste a mayor estancia en AVMi A assistência ventilatória mecânica invasiva (AVMi) em unidades de terapia intensiva pediátrica (UTIP) é uma prática onipresente, sua liberação é apoiada por preditores, não existindo nenhum que garanta o sucesso. Objetivos: Descrever o processo de liberação do MIAV e determinar os preditores de falha na extubação (FE). Pacientes e Métodos: Estudo retrospectivo, pacientes com mais de 48 horas de IMAV, período 11/2019 a 10/2023. Foram excluídos: falecidos, encaminhados para outra instituição e pacientes traqueostomizados. Foram comparadas características demográficas, estado ventilatório antes da extubação (AVMi e parâmetros hemogasométricos), variáveis relacionadas ao teste de ventilação espontânea e suporte pós-extubação [ventilação não invasiva (VNI)] dos grupos sucesso versus falha na extubação. determinar a existência de preditores. Resultados: foram registrados 510 eventos de extubação em 445 pacientes, com FE de 12,7%. Foram significativamente associados à FE: admissão por motivos respiratórios (92 vs 78%), maior frequência respiratória (22 vs 20 por minuto) e fração inspirada de O2 (0,32 vs 0,4) programada no ventilador e uso de VNI pós-extubação (51 contra 24%). Na análise multivariada, essa associação persistiu para maior volume corrente expirado antes da extubação e uso de VNI pós-extubação. FE resultou em mais dias em AVMi (10 vs 7) e em UTIP (13 vs 9). Conclusão: O maior volume corrente expirado antes da extubação e o uso de VNI pós-extubação foram preditores de FE, estando associados a maior permanência no IMAV. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2025-09-29 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion text/html application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/46292 10.31053/1853.0605.v82.n3.46292 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 82 No. 3 (2025); 615-632 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 82 Núm. 3 (2025); 615-632 Revista da Faculdade de Ciências Médicas de Córdoba; v. 82 n. 3 (2025); 615-632 1853-0605 0014-6722 10.31053/1853.0605.v82.n3 spa https://revistas.unc.edu.ar/index.php/med/article/view/46292/50478 https://revistas.unc.edu.ar/index.php/med/article/view/46292/50423 Derechos de autor 2025 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |