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Medicina interna de México
versión impresa ISSN 0186-4866
Resumen
SOSA-MEDELLIN, MA y MARIN-ROMERO, MC. Failed extubation in an intensive care unit of Mexico City. Med. interna Méx. [online]. 2017, vol.33, n.4, pp.459-465. ISSN 0186-4866.
BACKGROUND:
Invasive ventilatory support is a therapeutic measure commonly used in the Intensive Care Units, cured the disease that caused the ventilatory support begins with withdrawal of this modality. Once the withdrawal is performed, a failed extubation can occur in up to 20% of patients, requiring reintubation.
OBJECTIVE:
To report the frequency of failed extubation in the Adult Intensive Care Unit from the Hospital 1° de Octubre, ISSSTE, Mexico.
MATERIAL AND METHOD:
An analytical, observational and transversal study was made in the intensive care unit; files were analyzed in the period from March 1st, 2014 to February 28, 2015, with support of mechanical ventilation for more than 24 hours and extubated after a successful spontaneous breath trail.
RESULTS:
One hundred forty-six records were identified, 74 (51%) were female, with a mean age of 56 years. The indications for mechanical ventilation were: shock state 44 (30%), postoperative 40 (27%). The percentage of ventilation withdrawal failure was 18%. The risk of prevalence for failed extubation: for midazolam OR 4.8 (95% CI 1.56-14.8, p=0.002), obesity OR 2.5 (95% CI 1.07-6.16), neurological deterioration as an indication of ventilation OR 6 (95% CI 3.14-11.8), metabolic acidosis OR 5.2 (95% CI 1.2-22.6).
CONCLUSIONS:
The prevalence of failed extubation in our intensive care unit is 18%, similar to that reported in the literature.
Palabras llave : failed extubation; weaning; spontaneous breath trail; rapid shallow breathing index; cuff leak test.