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End-stage renal disease, cardiovascular failure predict extubation failure in obese patients

20 Aug 2017

Cardiovascular system-related respiratory failure, low maximal inspiratory pressure (MIP) and end-stage renal disease (ESRD) are correlated with the risk of extubation failure in obese patients, a new study has found.

Medical records of 595 adult obese patients (mean age 63.6±15.8 years; 67.7 percent male) who required mechanical ventilation and were scheduled for extubation were used in the study. Those without available weight and height data were excluded. Student’s t-test was used to determine the differences between successful and failed extubation cases, while multivariate logistic regression was used to determine variables that predict successful extubation.

Of the patients, 5.7 percent (n=34) experienced failed extubation. The most common cause of failure was haemodynamic instability (n=10). This was followed by excess secretions (n=8), upper airway obstructions (n=8), oxygen failure (n=6) and encephalopathy (n=2).

Those who had failed extubation were significantly older (p=0.004), had higher blood urea nitrogen (p=0.04), more ESRD (p<0.001), less negative MIP (p=0.001) and less positive maximum expiratory pressure (MEP; p=0.001).

Respiratory failure because of cardiovascular system failure (p=0.002) and mortality rates in the intensive care unit (p<0.001) and at 28 days (p<0.001) were also significantly higher in the failed extubation group.

Multivariate logistic regression showed that lower MIP levels (odds ratio [OR], 0.94; 95 percent CI, 0.90 to 0.97; p=0.001), ESRD (OR, 14.0; 6.21 to 31.35; p<0.001) and respiratory failure because of cardiovascular failure (OR, 2.60; 1.16 to 5.80; p=0.02) were significantly tied to higher risks of extubation failure.

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Most Read Articles
Jairia Dela Cruz, 05 Dec 2017
Discontinuation of aspirin may have detrimental consequences for long-term users, with a recent study reporting that cessation of use in the absence of major surgery or bleeding increases the risk of cardiovascular events.
19 Dec 2016
The prevalence of ECG for left ventricular hypertrophy (LVH) may vary depending on the criteria used across body mass index (BMI) categories in a low cardiovascular risk cohort, suggests a new study.
02 Dec 2017
The risk of congenital heart disease (CHD) Is significantly higher in foetuses conceived through in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), according to a recent study.
01 Mar 2015
Red yeast rice extracts have been used in traditional medicine for centuries.1 In recent times, an extract from red yeast rice, Xuezhikang® (XZK), has been studied for its role in dyslipidaemia and cardiovascular disease. This review will look at some of the clinical trials that have done so.