Establishing failure predictors for the planned extubation of overweight and obese patients

doi:10.1371/journal.pone.0183360

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Title:	Establishing failure predictors for the planned extubation of overweight and obese patients
Authors:	Chao, Chien-Ming Lai, Chih-Cheng Cheng, Ai-Chin Chiang, Shyh-Ren Liu, Wei-Lun Ho, Chung-Han Hsing, Shu-Chen Chen, Chin-Ming Cheng, Kuo-Chen
Contributors:	Chi Mei Med Ctr, Dept Intens Care Med Chi Mei Med Ctr, Dept Internal Med Chia Nan Univ Pharm & Sci Chi Mei Med Ctr, Dept Med Res Chi Mei Med Ctr, Dept Intens Care Med Chung Hwa Univ Med Technol, Dept Safety Hlth & Environm Engn
Keywords:	Intensive-Care-Unit Spontaneous Breathing Trial Mechanical Ventilation Cardiovascular-Disease Bariatric Surgery Mortality Outcomes Cohort Parameters Model
Date:	2017-08-16
Issue Date:	2018-11-30 15:55:54 (UTC+8)
Publisher:	Public Library Science
Abstract:	We investigated failure predictors for the planned extubation of overweight (body mass index [BMI] = 25.0-29.9) and obese (BMI >= 30) patients. All patients admitted to the adult intensive care unit (ICU) of a tertiary hospital in Taiwan were identified. They had all undergone endotracheal intubation for > 48 h and were candidates for extubation. During the study, 595 patients (overweight = 458 [77%]); obese = 137 [23%]) with planned extubation after weaning were included in the analysis; extubation failed in 34 patients (5.7%). Their mean BMI was 28.5 +/- 3.8. Only BMI and age were significantly different between overweight and obese patients. The mortality rate for ICU patients was 0.8%, and 2.9% for inpatients during days 1-28; the overall in- hospital mortality rate was 8.4%. Failed Extubation group patients were significantly older, had more end- stage renal disease (ESRD), more cardiovascular system- related respiratory failure, higher maximal inspiratory pressure (MIP), lower maximal expiratory pressure (MEP), higher blood urea nitrogen, and higher ICU- and 28-day mortality rates than did the Successful Extubation group. Multivariate logistic regression showed that cardiovascular- related respiratory failure (odds ratio [OR]: 2.60; 95% [confidence interval] CI: 1.16-5.80), ESRD (OR: 14.00; 95% CI: 6.25-31.35), and MIP levels (OR: 0.94; 95% CI: 0.90-0.97) were associated with extubation failure. We conclude that the extubation failure risk in overweight and obese patients was associated with cardiovascular system- related respiratory failure, ESRD, and low MIP levels.
Relation:	Plos One, v.12, n.8, e0183360
Appears in Collections:	[Dept. of Applied Foreign Languages] MOST Project

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