Predictive Value of Airway Occlusion Pressure, Maximal Inspiratory Pressure and Their Ratio for Successful Extubation in Patients with Traumatic Brain Injury | ||
| Benha Medical Journal | ||
| Article 778, Volume 42, Issue 7, July 2025, Pages 788-797 PDF (644.27 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/bmfj.2025.339274.2265 | ||
| Authors | ||
| Ali Rashad Ahmed Abd El Bary* 1; Ehab Ahmed Abdelrahman2; Eman Shafik Badr3; Samar Rafik Amin4 | ||
| 1Department of Anesthesia and Intensive Care, Faculty of Medicine, Benha University | ||
| 2Professor of Anesthesia and Intensive Care, Faculty of Medicine, Benha University | ||
| 3Lecturer of Critical Care Medicine, Faculty of Medicine, Benha University | ||
| 4Lecturer of Anesthesia and Intensive Care, Faculty of Medicine, Benha University | ||
| Abstract | ||
| Background: The treatment of mechanical ventilation (MV) is essential for patients who have experienced traumatic brain injury (TBI); however, it is associated with a variety of complications. This study aimed to assess the predictive value of respiratory muscle factors, such as maximal inspiratory pressure (PIMax), and central drive indicators, such as airway occlusion pressure (P0.1) and their ratio, in predicting the success of MV withdrawal in patients with TBI. Methods: In this prospective observational study, 60 ventilated TBI patients who were eligible for weaning were examined for a period of two hours, spontaneous breathing trials were implemented for all patients, utilizing low-level pressure support ventilation. The ventilator supplied the P0.1 and PIMax values. Results: PIMax can significantly predict successful ventilator weaning with AUC of 0.786, P-value -23 CmH2O with 78.95% sensitivity, 60.98% specificity. P0.1 was a significant predictor of successful ventilator weaning with AUC of 0.720, P-value of 0.010, and at cutoff value >2.6 CmH2O with 73.68% sensitivity, 51.22% specificity. P0.1/ PIMax ratio can significantly predict successful ventilator weaning with AUC of 0.776, P= 0.001, and at cutoff value >0.11 CmH2O with 84.21% sensitivity, 56.10% specificity. Conclusion: The weaning prognosis in TBI patients may be predicted by PIMax, P0.1, and the ratio of P0.1/PIMax, as evidenced by their moderate predictive accuracy. Patients with successful weaning showed lower ratio of P0.1/PIMax, PIMax, P0.1 higher PaO2/FiO2 ratio, lower RSBI, and lower number of days in the ICU. | ||
| Keywords | ||
| Airway Occlusion Pressure, Traumatic Brain Injury; Mechanical Ventilation, Maximal Inspiratory Pressure, Weaning | ||
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