Patients after surgical procedures have a high risk of extubation failure due to respiratory muscle dysfunction suppression, altered pulmonary mechanics and other factors. Reintubation increases the risk of ventilator-associated pneumonia and prolongs intensive care unit (ICU) length of stay. Noninvasive measurement of muscular pressure (Pmus) enables quantitative evaluation of respiratory muscle
Conditions
Interventions
Sponsors
The First Affiliated Hospital,Sun Yat-sen University
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1.Aged 18 to 80 years old, regardless of gender; patients admitted to the ICU with endotracheal intubation after major abdominal surgery (e.g., radical gastrectomy, hepatectomy), cardiothoracic surgery (e.g., coronary artery bypass grafting, lobectomy), or neurosurgical procedures (e.g., brain tumor resection, intracerebral hemorrhage evacuation). 2.Spontaneous breathing trial (SBT) was initiated during hospitalization, and complete SBT-related information (including SBT mode, parameter settings and SBT outcomes) was fully documented in the electronic medical records. 3.Complete Pmus monitoring data were available within 2 hours before and after the spontaneous breathing trial (SBT), including at least one record of peak Pmus before SBT and one record after SBT. Meanwhile, conventional weaning indicators (RSBI, P0.1, transpulmonary driving pressure, P/F ratio) were documented. 4.The medical records are complete, allowing traceability of extubation outcomes (success or failure) within 72 hours after extubation as well as complication information (such as pulmonary infection and causes of reintubation).
Exclusion criteria
Exclusion criteria: 1.Incomplete medical records with missing core variable documentation, including unclear SBT outcomes, more than 50% missing Pmus data, or absent 72-hour post-extubation follow-up information. 2.Special conditions or therapeutic interventions: patients complicated with severe coagulation disorders postoperatively (INR>2.0, platelet count <30×10?/L) receiving emergency blood transfusion; patients whose treatment was interrupted during SBT due to severe arrhythmia (e.g., ventricular fibrillation) or cardiac arrest; patients receiving extracorporeal membrane oxygenation (ECMO) or intra-aortic balloon pump (IABP) support. 3.Abnormal monitoring conditions: patients with endotracheal tube size less than 7.0 mm or greater than 8.0 mm, accompanied by ventilator leakage exceeding 30% of tidal volume (clearly documented in medical records); patients with distorted Pmus data caused by monitoring equipment malfunction (e.g., more than 3 equipment alarms recorded during monitoring without subsequent calibration). 4.Duplicated enrollment: patients who received repeated endotracheal intubation and multiple spontaneous breathing trials (SBTs) after the same surgical procedure; only data from the first SBT and corresponding extubation will be included in the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The area under the ROC curve (AUC) of pre-SBT 1-hour non-invasive peak-Pmus for predicting the success of spontaneous breathing trial.;The area under the ROC curve (AUC) of peak-Pmus during SBT for predicting 72-hour post-extubation failure.; | — |
Secondary
| Measure | Time frame |
|---|---|
| Various ventilation parameters of the spontaneous breathing test (breathing rate, shallow rapid breathing index, transpulmonary driving pressure, P0.1).;Comparison of Pmus parameters with traditional offline indicator predictive performance (AUC);Comparison of peak-Pmus and PTP-Pmus among different surgical subgroups.;Total duration of postoperative mechanical ventilation; | — |
Countries
China
Contacts
Public ContactHong Jiajia
The First Affiliated Hospital,Sun Yat-sen University
Outcome results
None listed