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Medicina crítica (Colegio Mexicano de Medicina Crítica)

Print version ISSN 2448-8909

Abstract

PALACIOS MORALES, Juan Carlos et al. Oxygenation indices, diastolic shock index, and time in support pressure as predictors of success in the removal of invasive mechanical ventilation in critically ill patients with COVID-19. Med. crít. (Col. Mex. Med. Crít.) [online]. 2022, vol.36, n.3, pp.132-137.  Epub Dec 05, 2022. ISSN 2448-8909.  https://doi.org/10.35366/105377.

Introduction:

The percentage of critically ill patients due to COVID-19 who tolerate the withdrawal of mechanical ventilation is minimal. It is essential to determine which are the predictors of success in weaning.

Objectives:

To determine if the oxygenation indices, time in pressure support, and diastolic shock index are predictors of success in the withdrawal of mechanical ventilation in critically ill patients due to COVID-19.

Material and methods:

Prospective cohort study in patients with COVID-19 who were admitted to the ICU and underwent tests of spontaneous ventilation, being later released from the mechanical ventilator. Demographic data, laboratory results, ventilatory parameters were collected in order to analyze and determine predictors of success in weaning.

Results:

A significant difference was found between those who tolerated and those who did not tolerate the withdrawal of mechanical ventilation in the following variables: rapid shallow breathing index 47 ± 17.9 vs 90 ± 20.2 (p = 0.08), days of mechanical ventilation 5.8 vs 9.3 (p = 0.03), prone sessions 1.36 vs 2.33 (p = 0.058), diastolic blood pressure 57 ± 3.6 (p = 0.027).

Conclusion:

In critically ill patients due to COVID-19 who are candidates for withdrawal from mechanical ventilation, we suggest using as predictors of success: Index of rapid shallow breaths < 64, days of mechanical ventilation < 8, diastolic blood pressure > 57 mmHg and having had a maximum two prone sessions as predictors of success in the withdrawal of mechanical ventilation.

Keywords : COVID-19; extubation; critically ill; predictors of success in weaning.

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