• Journal of critical care · Dec 2018

    Review

    Predictive factors of weaning from mechanical ventilation and extubation outcome: A systematic review.

    • Antuani Rafael Baptistella, Fabio Junior Sarmento, Karina Ribeiro da Silva, Shaline Ferla Baptistella, Marcelo Taglietti, Radamés Ádamo Zuquello, and João Rogério Nunes Filho.
    • Universidade do Oeste de Santa Catarina (UNOESC), Joaçaba, SC, Brazil; Programa de Pós-Graduação em Biociências e Saúde/Universidade do Oeste de Santa Catarina, Brazil; Hospital Universitário Santa Terezinha, Joaçaba, SC, Brazil. Electronic address: antuani.baptistella@unoesc.edu.br.
    • J Crit Care. 2018 Dec 1; 48: 56-62.

    PurposeTo identify, describe and discuss the parameters used to predict weaning from mechanical ventilation and extubation outcomes.MethodsSystematic review of scientific articles using four electronic databases: PubMed, Embase, PEDro and Cochrane Library. Search terms included "weaning", "extubation", "withdrawal" and "discontinuation", combined with "mechanical ventilation" and "predictive factors", "predictive parameters" and "predictors for success". In this study, we included original articles that presented predictive factors for weaning or extubation outcomes in adult patients and not restricted to a single disease. Articles not written in English were excluded.ResultsA total of 43 articles were included, with a total of 7929 patients and 56 different parameters related to weaning and extubation outcomes. Rapid Shallow Breathing Index (RSBI) was the most common predictor, discussed in 15 studies (2159 patients), followed by Age and Maximum Inspiratory Pressure in seven studies. The other 53 parameters were found in less than six studies.ConclusionThere are several parameters used to predict weaning and extubation outcomes. RSBI was the most frequently studied and seems to be an important measurement tool in deciding whether to wean/extubate a patient. Furthermore, the results demonstrated that weaning and extubation should be guided by several parameters, and not only to respiratory ones.Copyright © 2018 Elsevier Inc. All rights reserved.

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