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Neurocritical patients often face the need for removal of endotracheal tubes. However, despite following the extubation criteria for general critical ill patients, neurocritical patients still exhibit a higher rate of weaning failure, significantly higher than that of general critical ill patients. The extubation criteria for general critical patients emphasize the assessment of lung conditions. However, neurological critical patients often have less severe lung damage, but factors such as consciousness level and coughing ability may significantly influence extubation. Quantitative EEG serves as an objective tool to reflect consciousness level status, while bedside ultrasound can assess respiratory muscle function. Additionally, sputum volume may reflect the condition of lung condition. Therefore, we believe that combination of these three indicators can better predict the success of extubation for neurocritical patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Neurocritical Patients requiring weaning | The population in this study focused on neurocritical patients with endotracheal intubation. The data of quantitative EEG, beside ultrasound and sputum volume are all recorded for predicting weaning failure. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Quantitative EEG monitoring and beside ultrasound evaluation | Other | After successful spontaneous breathing trial, neurocritical patients undergo at least 2 hours of quantitative EEG monitoring before extubation. Additionally, bedside ultrasound assesses the thickness and variability of the diaphragm, intercostal muscles, rectus abdominis, transversus abdominis, and external oblique muscles. The sputum volume for the 24 hours prior to extubation is also recorded. Reintubation within 48 hours after extubation is defined as weaning failure. |
| Measure | Description | Time Frame |
|---|---|---|
| Quantitative EEG indicators | These indicators including amplitude EEG and the proportion of α,β,δ,θ wave | 2 hours before extubation |
| Respiratory muscles thickness in centimeter | Muscle thickness was evaluated by ultrasound. | 2 hours before extubation |
| Respiratory muscles thickening fraction (%) | Muscle thickening fraction was evaluated by ultrasound. It equals (end-inspiratory thickness - end-expiratory thickness)/end-expiratory thickness × 100%. | 2 hours before extubation |
| Sputum volume in milliliter | The amount of sputum | 24 hours before extubation |
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Inclusion Criteria:
Exclusion Criteria:
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The population in this study focused on neurocritical patients with endotracheal intubation. The data of quantitative EEG, beside ultrasound and sputum volume are all recorded for predicting weaning failure.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| bo yao, Dr. | Contact | +8618661800691 | icuyaobo@126.com |
| Name | Affiliation | Role |
|---|---|---|
| bo yao, Dr. | The Affiliated Hospital of Qingdao University | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35508676 | Result | Welte TM, Gabriel M, Hopfengartner R, Rampp S, Gollwitzer S, Lang JD, Stritzelberger J, Reindl C, Madzar D, Sprugel MI, Huttner HB, Kuramatsu JB, Schwab S, Hamer HM. Quantitative EEG may predict weaning failure in ventilated patients on the neurological intensive care unit. Sci Rep. 2022 May 4;12(1):7293. doi: 10.1038/s41598-022-11196-7. | |
| 29262440 |
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| Bosel J. Who Is Safe to Extubate in the Neuroscience Intensive Care Unit? Semin Respir Crit Care Med. 2017 Dec;38(6):830-839. doi: 10.1055/s-0037-1608773. Epub 2017 Dec 20. |