Respiratory failure & ventilation
Utilization of spontaneous breathing trial, objective cough test, and diaphragmatic ultrasound results to predict extubation success: COBRE-US trial
Authors' conclusion
Objective measurement of cough and diaphragmatic contraction velocity could be used to predict SBT success. The equation for predicting successful extubation, which includes SBT, cough, and diaphragmatic contraction velocity values, showed excellent discriminative capacity.
Study context
- Population
- Consecutive adults receiving invasive mechanical ventilation in 4 ICUs
- Participants
- 367 adults · 456 spontaneous breathing trial (SBTs)
- Comparison
- Predictive models combining cough intensity, diaphragmatic contraction velocity and SBT for SBT and extubation success
- Outcome
- Prediction of SBT success and extubation success (cuff leak test, rapid shallow breathing, cough intensity, DCV)
Methodological detailsconsecutive patients, 4 ICUs
- Consecutive patients
- 4 ICUs
Performance
As reported in the abstract
Prediction of SBT success and of extubation success (sensitivity, specificity, overall accuracy, AUC)
| Test or model | Equation | Cutoff | Sensitivity | Specificity | Overall accuracy | AUC |
|---|---|---|---|---|---|---|
| SBT model | (0.56 × Cough) - (0.13 × diaphragmatic contraction velocity (DCV)) + 0.25 | ≥ 0.83 | 91.5% | 22.1% | 76.2% | 0.63 |
| Extubation model | (5.7 × SBT) + (0.75 × Cough) - (0.25 × DCV) - 4.5 | ≥ 1.25 | 96.8% | 78.4% | 91.5% | 0.91 |
Equation
SBT model(0.56 × Cough) - (0.13 × DCV) + 0.25
Extubation model(5.7 × SBT) + (0.75 × Cough) - (0.25 × DCV) - 4.5
Cutoff
SBT model≥ 0.83
Extubation model≥ 1.25
Sensitivity
SBT model91.5%
Extubation model96.8%
Specificity
SBT model22.1%
Extubation model78.4%
Overall accuracy
SBT model76.2%
Extubation model91.5%
AUC
SBT model0.63
Extubation model0.91
Original publication
Utilization of spontaneous breathing trial, objective cough test, and diaphragmatic ultrasound results to predict extubation success: COBRE-US trial. Crit Care. Published 31 October 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →