• Respiratory care · Mar 2017

    The Integrative Weaning Index in Elderly ICU Subjects.

    • Leandro M Azeredo, Sérgio N Nemer, Carmen Sv Barbas, Jefferson B Caldeira, Rosângela Noé, Bruno L Guimarães, and Célia P Caldas.
    • Critical Care Department, Hospital da Polícia Militar de Niterói, Rua Martins Torres 245, Santa Rosa, Niterói, Rio de Janeiro, Brazil. azeredo.lm@gmail.com.
    • Respir Care. 2017 Mar 1; 62 (3): 333-339.

    BackgroundWith increasing life expectancy and ICU admission of elderly patients, mechanical ventilation, and weaning trials have increased worldwide.MethodsWe evaluated a cohort with 479 subjects in the ICU. Patients younger than 18 y, tracheostomized, or with neurologic diseases were excluded, resulting in 331 subjects. Subjects ≥70 y old were considered elderly, whereas those <70 y old were considered non-elderly. Besides the conventional weaning indexes, we evaluated the performance of the integrative weaning index (IWI). The probability of successful weaning was investigated using relative risk and logistic regression. The Hosmer-Lemeshow goodness-of-fit test was used to calibrate and the C statistic was calculated to evaluate the association between predicted probabilities and observed proportions in the logistic regression model.ResultsPrevalence of successful weaning in the sample was 83.7%. There was no difference in mortality between elderly and non-elderly subjects (P = .16), in days of mechanical ventilation (P = .22) and days of weaning (P = .55). In elderly subjects, the IWI was the only respiratory variable associated with mechanical ventilation weaning in this population (P < .001).ConclusionsThe IWI was the independent variable found in weaning of elderly subjects that may contribute to the critical moment of this population in intensive care.Copyright © 2017 by Daedalus Enterprises.

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