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A pilot study to investigate any relationship between sustained maximal inspiratory pressure and extubation outcome
1School of Health Professions and Rehabilitation Sciences, University of Southampton, Highfield, Southampton SO17 1BJ, UK.
Objective:
To establish whether any relationship exists between extubation outcome and sustained maximal inspiratory pressures (SMIP).
Design And Setting:
Prospective clinical study in the 7-bed general intensive care unit of a university hospital.
Subjects:
Twenty-seven intubated adults who were deemed ready for extubation were enrolled.
Measurements:
Standard respiratory parameters and inspiratory muscle function data (ie, SMIP and peak maximal inspiratory pressures [MIP]) were recorded before extubation.
Results:
SMIP was found to be significantly greater in those who were successfully extubated than in those who underwent a failed extubation (P <.01). Receiver operating characteristic curves for SMIP data indicated that a cutoff point of 57.5 pressure time units would give a sensitivity and specificity of 1.0 for extubation outcome prediction. Peak MIP was also significantly greater in those successfully extubated (P =.04); a cutoff point of 17.5 cm H(2)O gave a sensitivity of 1.0 and a specificity of 0.5.
Conclusions:
In this study, peak MIP was not specific enough to be clinically useful as a predictor of extubation outcome. SMIP was associated with extubation outcome with equally high sensitivity and specificity and may therefore have a role in outcome prediction.