Mortality rate and weaning success vary according to the degree of change in basic activities following active training in patients who were tracheotomized, ventilated, and difficult-to-wean, say authors of an article published online ahead of print November 16, 2010, in Respiratory Care. Broadest muscle of back performance was the only significant predictor of change in these activities, the researchers add.
In a prospective cohort study, the investigators observed 77 patients who were tracheotomized (aged 75±7 yrs) admitted for difficult weaning in a regional weaning center (RICU). Care plan including peripheral muscle training was delivered on a daily basis. Demographic, anthropometric and functional characteristics were measured at admission in all patients. Pre-to-post change in basic activity of daily living score (Δ-BADL), survival and weaning success rate were recorded as clinical outcomes. Pearson's correlation analysis and a linear regression model with Δ-BADL as the dependent variable were performed to test the predictive power of any measurement taken at baseline.
Sixty-seven patients (87%) survived whereas 55 of them (74%) succeeded weaning during stay in RICU. Δ-BADL was +2.53 point (SD 2.03, median 2). Performance of the broadest muscle of back (BMB) at baseline predicted Δ-BADL (β 0.388). Probability to remain ventilator-free and to survive differed across the categories of Δ-BADL (0=no change, 1-2=least improvement, and >2=improvement above median change).
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