Clinical prediction of weaning and extubation in Australian and New Zealand intensive care units.

Abstract:

:Our objective was to describe, in Australian and New Zealand adult intensive care units, the relative frequency in which various clinical criteria were used to predict weaning and extubation, and the weaning methods employed. Participant intensivists at 55 intensive care units completed a self-administered questionnaire, using visual analogue scales (0 = not at all predictive, 10 = perfectly predictive, not used = null score) to record the perceived utility of 30 potential predictors. Survey response rate was 71% (164/230). Those variables thought most predictive of weaning readiness were respiratory rate (median score 8.0, interquartile range 7.0 to 8.6) effective cough (7.3, 5.9 to 8.2) and pressure support setting (7.2, 6.0 to 8.0). The most highly rated predictors of extubation success were effective cough (8.0, 7.0 to 9.0), respiratory rate (8.0, 7.0 to 8.5) and Glasgow Coma Score (7.9, 6.1 to 8.3). Variables perceived least predictive of weaning and extubation success were P0.1, Acute Physiological and Chronic Health Evaluation score II, mean arterial pressure, electrolytes and maximum inspiratory pressure (individual median scores < 5). Most popular clinical criteria were those perceived to have high predictive accuracy, both for weaning (respiratory rate 96%, pressure support setting 94% and Glasgow coma score 91%) and extubation readiness (respiratory rate 98%, effective cough 94% and Glasgow Coma Score 92%). Weaning mostly employed pressure support ventilation (55%), with less use of synchronised intermittent mandatory ventilation (32%) and spontaneous breathing trials (13%). Classic ventilatory performance predictors including respiratory rate and effective cough were reported to be of greater clinical utility than other more recently proposed measures.

journal_name

Anaesth Intensive Care

authors

Rose L,Presneill JJ

doi

10.1177/0310057X1103900414

subject

Has Abstract

pub_date

2011-07-01 00:00:00

pages

623-9

issue

4

eissn

0310-057X

issn

1448-0271

pii

20100559

journal_volume

39

pub_type

杂志文章
  • Intraoperative assessment of the Lawrence 3000 Doppler Cardiac Output Monitor.

    abstract::Transoesophageal Doppler cardiac output measurement was evaluated against the thermodilution method in eleven patients undergoing elective cardiac surgery. A total of 106 pairs of Doppler and thermodilution values were obtained. Cardiac output was measured over a range of 2.3 l.min-1. to 11.51 l.min-1. The mean differ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9101900219

    authors: Stein MS,Barratt SM,Purcell GJ

    更新日期:1991-05-01 00:00:00

  • Single quadrant sub-Tenon's block. Evaluation of a new local anaesthetic technique for eye surgery.

    abstract::The sub-Tenon's technique uses blunt dissection and a blunt probe to inject local anaesthetic into the posterior sub-Tenon's space. This avoids the potentially catastrophic complications which result from passing a sharp needle blindly into the orbit and retrobulbar space. The anatomy of Tenon's capsule and the block ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9602400217

    authors: Guise PA

    更新日期:1996-04-01 00:00:00

  • Comparison of remifentanil and fentanyl in anaesthesia for elective cardioversion.

    abstract::This prospective, randomized, double-blind study was designed to compare the recovery characteristics of remifentanil and fentanyl in combination with propofol for direct current cardioversion. Patients undergoing elective cardioversion received either intravenous fentanyl 1 microg/kg (n=33) or remifentanil 0.25 micro...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0310057X0603400309

    authors: Maltepe F,Kocaayan E,Ugurlu BS,Akdeniz B,Guneri S

    更新日期:2006-06-01 00:00:00

  • Retro-orbital tumour--an uncommon cause of headache in pregnancy.

    abstract::Retro-orbital tumour was the cause of headache and neuropathic facial pain in a 31-year-old pregnant woman. The diagnosis had been overlooked as a result of a long history of migraine. There was exacerbation of the pain throughout the pregnancy, particularly in the third trimester. Pharmacological agents commonly used...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0102900310

    authors: Roberts LJ,Goucke CR

    更新日期:2001-06-01 00:00:00

  • Adverse local reactions to amethocaine cream--audit and case reports.

    abstract::Amethocaine has recently been introduced as a topical local anaesthetic preparation. Following sporadic reports of severe local adverse effects, we conducted an audit of 372 children attending our hospital for day surgery. We conclude that 4% amethocaine cream is a safe and effective topical anaesthetic and that the i...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9802600316

    authors: Wongprasartsuk P,Main BJ

    更新日期:1998-06-01 00:00:00

  • Intravenous lipid emulsion for levobupivacaine intoxication in acidotic and hypoxaemic pigs.

    abstract::Intravenous lipid emulsion is, in some countries, the recommended treatment for local anaesthetic toxicity. Systemic local anaesthetic toxicity results in hypoxaemia and acidosis, and whether this influences the effects of lipid therapy on drug concentrations and cardiovascular recovery is currently unknown. Twenty an...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1604400214

    authors: Heinonen JA,Skrifvars MB,Haasio J,Backman JT,Rosenberg PH,Litonius E

    更新日期:2016-03-01 00:00:00

  • Association between perioperative glucose levels and adverse outcomes in infants receiving open-heart surgery with cardiopulmonary bypass for congenital heart disease.

    abstract::There is no consensus that hyperglycaemia is an independent predictor of morbidity-mortality in children. This retrospective observational study aimed to assess the association between abnormal perioperative glucose levels and adverse outcomes in infants receiving open-heart surgery with cardiopulmonary bypass. The re...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1204000506

    authors: Huang XZ,Wang H,Xu HZ,Ye M,Jiang P,Xu Y

    更新日期:2012-09-01 00:00:00

  • Use of inhaled nitric oxide in pulmonary embolism.

    abstract::Acute massive pulmonary embolism carries a high mortality with the majority of deaths occurring during the early phase. We describe a case of massive pulmonary embolism resulting in severe cardiovascular collapse and cardiac arrest which was treated successfully with inhaled nitric oxide. ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9902700415

    authors: Crerar-Gilbert A,Boots R

    更新日期:1999-08-01 00:00:00

  • Acute intracranial hypertension occurring during infusion of stable plasma protein solution.

    abstract::A case of traumatic cerebral oedema is reported in which the infusion of small volumes of stable plasma protein solution (SPPS) resulted in acute and massive increases in intracranial pressure. The batch of SPPS responsible was found to have high levels of prekallikrein activator which is thought to be the cause of th...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8000800416

    authors: Duncan AW,Gleeson MT

    更新日期:1980-11-01 00:00:00

  • Palatopharyngeal wall perforation during Glidescope intubation.

    abstract::We report a case of palatopharyngeal wall perforation during intubation with a GlideScope laryngoscope. The likely mechanism was advancing and rotating the endotracheal tube against a taut palatopharyngeal fold. This was missed during the initial laryngoscopy, because there is a potential blind-spot in the oropharynx ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,评审

    doi:10.1177/0310057X0803600620

    authors: Leong WL,Lim Y,Sia AT

    更新日期:2008-11-01 00:00:00

  • Prophylactic intramuscular ephedrine prior to caesarean section.

    abstract::Thirty healthy parturients, having given informed consent, were randomly allocated in a double-blind study to receive an intramuscular injection of either 0.9% sodium chloride (control), ephedrine 25 mg, or ephedrine 50 mg, 30 minutes prior to general anaesthesia for caesarean section. Nine patients (90%) in the 50 mg...

    journal_title:Anaesthesia and intensive care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1177/0310057X9202000408

    authors: Rout CC,Rocke DA,Brijball R,Koovarjee RV

    更新日期:1992-11-01 00:00:00

  • Attitudes and practices of New Zealand anaesthetists with regard to emergency drugs.

    abstract::A postal survey of anaesthetists practising in New Zealand assessed practices with regard to the preparation of pre-drawn syringes of emergency drugs in theatre, and attitudes towards the drawing up of drugs by non-medically qualified assistants. Opinion and practice varied widely; a quarter of respondents routinely d...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0002800616

    authors: Ducat CM,Merry AF,Webster CS

    更新日期:2000-12-01 00:00:00

  • Anaesthetic experience with cryotherapy for treatment of hepatic malignancy.

    abstract::Hepatic cryotherapy is a relatively new technique, currently employed in the treatment of unresectable liver malignancy, which involves direct freezing of tumour deposits with liquid nitrogen. In a review of 26 patients undergoing this procedure, the anaesthetic considerations are defined. The total operation time ran...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9202000418

    authors: Goodie DB,Horton MD,Morris RW,Nagy LS,Morris DL

    更新日期:1992-11-01 00:00:00

  • Computer controlled studies in surface cooling hypothermia: the effect of carbon dioxide on brain temperature.

    abstract::A computer controlled ventilation system was employed to maintain a constant end-expired CO2 percentage (FECO2) during a series of studies on young dogs aimed at measuring brain temperature differences during surface cooling hypothermia. The conclusion is that an FECO2 of six per cent or more is desirable if brain tem...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X7600400107

    authors: Brown TC,Lampard DG,Brown WA,Coles JR

    更新日期:1976-02-01 00:00:00

  • Anaesthetic management of a patient with Emery-Dreifuss muscular dystrophy.

    abstract::Emery-Dreifuss muscular dystrophy is a rare form of muscular dystrophy associated with cardiac implications such as cardiomyopathy and arrhythmias leading to sudden death. We describe the anesthetic management of a patient with Emery-Dreifuss muscular dystrophy who presented for orthopaedic surgery and discuss the dis...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0203000320

    authors: Shende D,Agarwal R

    更新日期:2002-06-01 00:00:00

  • Australian snake antivenom dosing: What is scientific and safe?

    abstract::Because the median dose of one vial 'clears the blood of circulating venom', the authors of the Australian Snakebite Project recommend restriction of antivenom to one vial for all envenomated victims. This is neither scientific nor safe. Methodological flaws in the case series include limited detection of venom toxins...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X19865268

    authors: Tibballs J

    更新日期:2020-03-01 00:00:00

  • Organic insecticides.

    abstract::Organic insecticide poisoning continues to be a major health problem not only in the developing communities but also in the Western population. The insecticides commonly used are the organophosphates, organocarbamates, organochlorides and pyrethroids. Patients with organic insecticide poisoning present with a spectrum...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,评审

    doi:10.1177/0310057X0002800102

    authors: Peter JV,Cherian AM

    更新日期:2000-02-01 00:00:00

  • Substance abuse by anaesthetists in Australia and New Zealand.

    abstract::A questionnaire investigating substance abuse was sent to 128 anaesthetic departments in Australia and New Zealand of which 100 (78%) replied. Forty-four cases of substance abuse were reported. Abusers were more likely to be male, aged between 25 and 35 years and abusing opioids. Death was the eventual outcome in 24% ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0503300216

    authors: Fry RA

    更新日期:2005-04-01 00:00:00

  • The bispectral index during an anaphylactic circulatory arrest.

    abstract::A 47-year-old woman with Cushing's syndrome suffered a severe anaphylactic reaction on induction of anaesthesia, resulting in circulatory arrest. A spontaneous cardiac output appeared after 25 minutes of chest compression and she regained consciousness three hours later, with no neurological deficit. A Bispectral Inde...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0102900518

    authors: Kluger MT

    更新日期:2001-10-01 00:00:00

  • Equivalent metabolic acidosis with four colloids and saline on ex vivo haemodilution.

    abstract::Colloid infusions can cause metabolic acidosis. Mechanisms and relative severity with different colloids are incompletely understood. We compared haemodilution acid-base effects of 4% albumin, 3.5% polygeline, 4% succinylated gelatin (all weak acid colloids, strong ion difference 12 mEq/l, 17.6 mEq/l and 34 mEq/l resp...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0903700304

    authors: Morgan TJ,Vellaichamy M,Cowley DM,Weier SL,Venkatesh B,Jones MA

    更新日期:2009-05-01 00:00:00

  • Difficulties with positioning Robertshaw double lumen tubes.

    abstract::Difficulties in positioning Robertshaw tubes have been reviewed in a retrospective and a prospective series. Pre-operative cheat X-rays did not help in predicting difficulties. The performance of the Robertshaw tube was carefully recorded for each malposition in the prospective series, and the relationship of the malp...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X7500300404

    authors: Black AM,Harrison GA

    更新日期:1975-11-01 00:00:00

  • Thickly and thinly applied lignocaine-prilocaine cream prior to venepuncture in children.

    abstract::EMLA cream (Astra Pharmaceuticals) which contains lignocaine and prilocaine, is widely used in a thick layer to reduce the pain associated with venepuncture. Application of smaller amounts of cream lowers cost and may reduce side-effects. The efficacy of a thick layer (using 2.0 ml) and a thin layer (using 0.5 ml) of ...

    journal_title:Anaesthesia and intensive care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1177/0310057X9101900305

    authors: Sims C

    更新日期:1991-08-01 00:00:00

  • Peripheral tissue oxygenation and the number of organs transplanted per donor.

    abstract::Current donor management practices target macrohaemodynamic parameters, but it is unclear if this leads to improvements in microvascular perfusion and tissue oxygenation; the latter may have more impact on organ status. In a recent preclinical study we determined that brain death impaired tissue perfusion and oxygen u...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1804600611

    authors: Perez-Protto SE,Reynolds JD,Nazemian R,You J,Hata JS,Latifi SQ,Lebovitz DJ

    更新日期:2018-11-01 00:00:00

  • Anaesthetic breathing circuit obstruction due to blockage of tracheal tube connector by a foreign body--two cases.

    abstract::Two cases are presented which illustrate the disastrous consequences possible when an anaesthetic breathing circuit is obstructed by a foreign body. Despite reports of previous similar cases, work practices and equipment manufacture or design continue to allow for such events to occur. The importance of both pre-anaes...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9902700116

    authors: Foreman MJ,Moyes DG

    更新日期:1999-02-01 00:00:00

  • Low dose chlormethiazole infusion as a supplement to central neural blockade: blood concentrations and clinical effects.

    abstract::Chlormethiazole ethanedisulphonate (Hemineurin) was administered to provide light sedation in patients undergoing surgery with neural blockade. A two stage intravenous infusion system was used and consisted of a loading dose 1520 mg over 30 minutes followed by a maintenance rate of 10 mg/min for the desired period. Pa...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8000800405

    authors: Mather LE,Cousins MJ

    更新日期:1980-11-01 00:00:00

  • A comparison of parametric and non-parametric approaches to target-controlled infusion of propofol.

    abstract::Nineteen adult patients of either gender received intravenous infusions of propofol, scaled to estimated lean body mass (LBM), for 150 minutes as part of a balanced anaesthetic. Arterial blood was assayed for whole blood propofol. The first subject received propofol at a fixed rate of 0.058 mg x min(-1) x kg(LBM)(-1)....

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1003800305

    authors: Crankshaw DP,Brown MJ,Bjorksten AR

    更新日期:2010-05-01 00:00:00

  • The Australian Incident Monitoring Study. Problems before induction of anaesthesia: an analysis of 2000 incident reports.

    abstract::The first 2000 incidents reported to the Australian Incident Monitoring study (AIMS) were examined to identify those incidents which occurred preoperatively (defined as occurring prior to the commencement of general or regional anaesthesia). The 35 incidents, representing 1.7% of the total, which occurred in this time...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9302100516

    authors: Ludbrook GL,Webb RK,Fox MA,Singleton RJ

    更新日期:1993-10-01 00:00:00

  • A retrospective observational study of sarcopenia and outcomes in critically ill patients.

    abstract::Frailty assessment in patients admitted to intensive care is often limited using traditional clinical frailty assessment tools. Opportunistic use of contemporary computed tomography (CT) can provide an objective estimate of low skeletal muscle mass (sarcopenia) as a proxy for frailty. The aim of this study was to esta...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X20922234

    authors: Joyce PR,O'Dempsey R,Kirby G,Anstey C

    更新日期:2020-05-01 00:00:00

  • An analysis of the performance of a variable venturi-type oxygen mask.

    abstract::The theoretical performance of the Hudson Multivent mask is considered. A method is described of determining the flow-weighted mean inspired oxygen concentration produced by the mask. Using this method, it was found that the inspired oxygen concentration was predictable only at the 24% setting using the recommended fl...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8000800109

    authors: Woolner DF,Larkin J

    更新日期:1980-02-01 00:00:00

  • The Lack and Bain systems in spontaneous respiration.

    abstract::In conscious subjects breathing spontaneously the performance of the Lack semi-closed system resembled the Magill attachment in that rebreathing was only detected at fresh gas flows of less than resting minute volume. With the Bain semi-closed system rebreathing was detectable at fresh gas flows of the order of 2.5 ti...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8201000407

    authors: Nott MR,Walters FJ,Norman J

    更新日期:1982-11-01 00:00:00