Correlation of spirometry Parameters and Clinical Variables among Post Extubated Patients in Selected Intensive Care Unit of Tertiary Care Hospital

Document Type : Original Article

Authors

1 Nurse practitioner, Swami Rama Himalayan University, Dehradun, India

2 Himalayan College of Nursing, Dehradun, India

3 Pulmonary medicine, Department of Pulmonary Medicine, Swami Rama Himalayan University, Dehradun, India

4 Department of Nursing, Swami Rama Himalayan University, Dehradun, India

5 Department of Respiratory Medicine, Swami Rama Himalayan University, Dehradun, India

Abstract

Introduction: Intubation is the common medical procedure which involves the insertion of a plastic tube which is a flexible tube in the throat of the patient. Reintubation is described as the failed extubation or patient get intubation after extubation who had been initially tracheal intubated.The purpose of the study was to determine the Spiro metric parameters among post Extubated patients and the application of Non-Invasive Ventilation for - prevention of reintubation.
Materials and Method: Quantitative research approach with purposive sampling technique was adopted to include 38 participants. Data were collected by providing spirometry immediately after extubation. The data were analyzed using descriptive statistics.
Results: The result shows that 36.84% of participants required non-invasive ventilation after extubation who were having FEV1 between 0.38-1.48, FVC between 0.44-1.75, PEFR between50-70. Hemodynamic variable like saturation (0.01), PCO2 (0.00), PO2 (0.03), and HCO3 (0.00) were highly significant at the level of p < 0.05. Proving that patients whose saturation level& ABG profile like PCO2, PO2, and HCO3 are not maintained required NIV after extubation.
Conclusion: Study concludes that in Extubated patient’s prophylactic non-invasive ventilation prevents extubation failure assessing the Spiro metric parameters in patients who can maintain saturation with less oxygen support, is also important in predicting good outcome of non-invasive ventilation after extubation.

Keywords

References

  1. Boles JM, Bion J, Connors A, Herridge M, Marsh B, Melot C, Pearl R, Silverman H, Stanchina M, Vieillard-Baron A, Welte T. Weaning from mechanical ventilation. European Respiratory Journal. 2007 May 1;29(5):1033-56.
  2. Coplin Wm, Pierson Dj, Cooley Kd, Newell Dw, Rubenfeld Gd. Implications of extubation delay in brain-injured patients meeting standard weaning criteria. American journal of respiratory and critical care medicine. 2000 May 1;161(5):1530-6.
  3. Unroe M, Kahn JM, Carson SS, Govert JA, Martinu T, Sathy SJ, Clay AS, Chia J, Gray A, Tulsky JA, Cox CE. One-year trajectories of care and resource utilization for recipients of prolonged mechanical ventilation: a cohort study. Annals of internal medicine. 2010 Aug 3;153(3):167-75..
  4. Epstein SK, Ciubotaru RL, Wong JB. Effect of failed extubation on the outcome of mechanical ventilation. Chest. 1997 Jul 1;112(1):186-92.
  5. Terzi N, Lofaso F, Masson R, Beuret P, Normand H, Dumanowski E, Falaize L, Sauneuf B, Daubin C, Brunet J, Annane D. Physiological predictors of respiratory and cough assistance needs after extubation. Annals of intensive care. 2018 Dec;8(1):1-0.
  6. Yang KL, Tobin MJ. A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. New England Journal of Medicine. 1991 May 23;324(21):1445-50.
  7. MacIntyre NR. New modes of mechanical ventilation. Clinics in chest medicine. 1996 Sep 1;17(3):411-21.
  8. Delisle S, Francoeur M, Albert M, Ouellet P, Bellemare P, Arsenault P. Preliminary evaluation of a new index to predict the outcome of a spontaneous breathing trial. Respiratory care. 2011 Oct 1;56(10):1500-5.
  9. Hess DR. Mechanical ventilation strategies: what's new and what's worth keeping?. Respiratory care. 2002 Sep 1;47(9):1007-17.
  10. Cruz LS, Monterroso C, Datta D. Breathing Index During Cardiopulmonary Exercise Testing In Patients With Dyspnea And Its Relation To Spirometric Indices And Breathing Reserve. InA78. Ready... Set... Go: All About Exercise Physiology 2017 May (Pp. A2552-A2552). American Thoracic Society.
  11. Osadnik CR, Tee VS, Carson‐Chahhoud KV, Picot J, Wedzicha JA, Smith BJ. Non‐invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2017(7).
  12. Duan J, Han X, Huang S, Bai L. Noninvasive ventilation for avoidance of reintubation in patients with various cough strength. Critical Care. 2016 Dec;20(1):1-7.
  13. Mokaberi P, Babayan-Mashhadi F, Amiri Tehrani Zadeh Z, Saberi MR, Chamani J. Analysis of the interaction behavior between Nano-Curcumin and two human serum proteins: combining spectroscopy and molecular stimulation to understand protein-protein interaction J Biomol Struct Dyn. 2021; 39(9):3358-3377.
  14. Quinnell TG, Pilsworth S, Shneerson JM, Smith IE. Prolonged invasive ventilation following acute ventilatory failure in COPD: weaning results, survival, and the role of noninvasive ventilation. Chest. 2006 Jan 1;129(1):133-9.
  15. Burns KE, Meade MO, Premji A, Adhikari NK. Noninvasive positive‐pressure ventilation as a weaning strategy for intubated adults with respiratory failure. Cochrane database of systematic reviews. 2013(12).
  16. Housaindokht MR, Chamani J, Saboury AA, Moosavi-Movahedi AA, Bahrololoom M. Three binding sets analysis of alpha-Lactalbumin by interaction of tetradecyl trimethyl ammonium bromide. Bull Korean Chem Soc. 2001; 22(2):145-148.
  17. Glossop AJ. Noninvasive Ventilation for Weaning, Avoiding ReintubationAfterExtubation, and in the Postoperative Period. InNoninvasive Mechanical Ventilation and Difficult Weaning in Critical Care 2016 (pp. 183-189). Springer, Cham.
  18.  
Journal of Cardio-Thoracic Medicine
Volume 9, Issue 3
September 2021
Pages 845-853

Files

Share

How to cite

Statistics