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Mean platelet volume is useful for predicting weaning failure: a retrospective, observational study
Yingying Zheng1, Zujin Luo2, Zhixin Cao2
1Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. zyy19831016@163.com.
BMC Anesthesiology
|May 25, 2022
Summary
Mean platelet volume (MPV) is a better predictor of weaning failure in patients on invasive mechanical ventilation (IMV) than other inflammation markers. Higher MPV levels indicate a high risk for weaning failure, requiring careful evaluation before extubation.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Hematology
Background:
- Invasive mechanical ventilation (IMV) is a critical support for respiratory failure.
- Predicting successful weaning from IMV remains a clinical challenge.
- Inflammation markers are explored for their prognostic value in weaning outcomes.
Purpose of the Study:
- To assess the predictive value of mean platelet volume (MPV) for weaning failure in IMV patients.
- To compare MPV's efficacy against traditional inflammation markers like leukocyte count and C-reactive protein (CRP).
Main Methods:
- A retrospective observational study included 261 patients undergoing IMV and spontaneous breathing trials (SBT).
- MPV, leukocyte count, and CRP levels were compared between patients with weaning success and failure.
- Receiver-operating characteristic (ROC) curves and multivariate logistic regression were used for analysis.
Main Results:
- Mean platelet volume (MPV) demonstrated superior predictive performance for weaning failure (AUC 0.777) compared to leukocyte count (AUC 0.6) and CRP (AUC 0.627).
- A cutoff MPV value of 11.3 fL predicted weaning failure with 55.56% sensitivity and 87.92% specificity.
- Elevated MPV (>11.3 fL) was identified as an independent risk factor for weaning failure.
Conclusions:
- Mean platelet volume (MPV) is a valuable and potentially superior marker for predicting weaning failure in IMV patients.
- Patients with MPV > 11.3 fL require heightened vigilance and tailored post-extubation strategies due to high weaning failure risk.
- Consideration of noninvasive ventilation, high-flow nasal cannula oxygen therapy, or early tracheostomy may benefit high-risk patients.
