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Centre for Evidence-
Based Medicine

Successful Extubation: How to diagnose

Citation

Yang KL, Tobin MJ.
A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation.
N Engl J Med 1991; 324:1445-50.

Clinical Question

In mechanically ventilated patients, can the respiratory rate to tidal volume ratio be used to predict successful extubation?

Search Terms

'extubation' and 'sensitivity' and 'specificity'

The Study

  1. Target disorder and gold standard; Successful extubation
  2. Study setting: mechanically ventilated patients in an an ICU

The Evidence

Respiratory rate to tidal volume ratio Successful extubation Failed extubation Likelihood ratio
< 80 29/32 3/32 7.53
80-100 6/12 6/12 0.77
> 100 1/20 19/20 0.04
Totals 36 28

Comments

  1. Study designed to evaluate weaning but outcome was successful extubation.
  2. Jaeschke RZ, Meade MO, Guyatt GH, Keenan SP, Cook DJ.
    How to use diagnostic test articles in the intensive care unit: Diagnosing Weanability using f/VT.
    Crit Care Med 1997; 25:1514-21.

    This article provides an excellent review of how to evaluate an article about a diagnostic test.

Appraised By

Pronovost 1999

Expiry Date

2000