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VALUE OF CENTRAL VENOUS OXYGEN SATURATION TO DETECT WEANING FAILUREIN SEVERE ACUTE MYOCARDIAL INFRACTIONWHO MUST INVASIVE MECHANICAL VENTILATION
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Abstract
Objectives: To evaluate the ability of central venous oxygen saturation (ScvO2) to detect weaningfailure(WF) in severe acute myocardial infraction(MI) who must invasive mechanical ventilation (MV) >72 hours. Methods: prospective observational study was conducted at cardiac intensive care unit C1 Bach Mai Hospital in severe MI needed mechanical ventilation >72 hours,fulfilling of the weaning criteria and have the clinical decision for spontaneous breathing trial (SBT). We collected the clinical, subclinical information and 2 samples of central venous blood gas before the SBT (T1) and 30th min of SBT(T2). Result: Twenty five patients were enrolled in the study, there were fourteensuccessful weaning patients and eleven failed weaning patients. At the T2, ScvO2 decreased significantly while the heart increased significantly between two group (69.87±3.9% vs 63.84±6.54%; p=0.009; 103.5(99.5-107) vs 111.0(106-113); p=0.008). In our study, a reduction of ScvO2 by >4.5% between before and the 30th min of SBT can predict weaning failure with sensivity 72.7%, Specificity 85.7% and odds ratio 16 (confidence interval= 2.165 – 118.27,p=0.005). Conclusion: reduction of ScvO2 between before and the 30th min of SBT can predictability in weaning failure detection in severe myocardial infraction who needs invasive mechanical ventilation.
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Keywords
ScvO2, Myocardial infraction, Mechanical ventilation
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