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The Change of Central Vein Oxygen Saturation Level during Spontaneous Breathing Trial as a Predictor of Successful Extubation in Intensive Care Unit

Year: 2025

Type: article

Abstract: Background Weaning from mechanical ventilation is an essential step in the care of critically ill patients. Central venous oxygen saturation (ScvO2) could reflect tissue oxygenation. Objective The evaluation of the difference in ScvO2 values at the beginning and end of the Spontaneous Breathing Trial (SBT) can be used as a predictor of successful extubation in critically ill patients. Methods This cross-sectional study was conducted in the ICU of Prof. Dr. I.G.N.G. Ngoerah Hospital from July to August 2024. This study involved 42 adult patients aged 18-65 who were using mechanical ventilation during their admission to the ICU. All patients had central venous access, were clinically ready for mechanical ventilation weaning, and could attempt SBT for 30-120 minutes with a rapid shallow breathing index (RSBI) of less than 105. Results All patients underwent 30-120 minutes of SBT. ScvO2 levels were measured at the beginning of SBT (first minute) and at 30 minutes after SBT started, and the change in ScvO2 level was recorded (ΔScvO2). Patients with RSBI < 105 measured during SBT were extubated. Extubation failure was defined as the need for re-intubation, or patients died within 48 hours after extubation. Of 42 patients, 37 patients (89.1%) were successfully extubated. There was a significant difference in ΔScvO2 between successfully extubated patients and those who failed (-2.89±1.63 vs. -8.2±4.27; p=0.049). The ROC curve analysis showed that a decrease in ScvO2 ≤4.5% was the most optimal cut-off for a predictor of successful extubation with a sensitivity of 81.1%, specificity of 60%, positive predictive value of 93.8% and negative predictive value of 70%. Conclusion The difference in ScvO2 between the beginning and after 30 minutes of SBT was a valuable early predictor for successful extubation from mechanical ventilation.

Source: The Open Respiratory Medicine Journal

DOI: 10.2174/0118743064363511250304050459

Authors: Made Wirga Wirgunatha, Bianca Jeanne, Tjokorda Gde Agung Senapathi, Putu Agus Surya Panji, I. Wayan Suranadi

Institution: Udayana University

Language: English

Topic: Respiratory Support and Mechanisms

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4409306136

FWCI:

Cites: 14

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Related to: 10