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A pilot study to investigate any relationship between sustained maximal inspiratory pressure and extubation outcome.

OBJECTIVE
To establish whether any relationship exists between extubation outcome and sustained maximal inspiratory pressures (SMIP).


DESIGN AND SETTING
Prospective clinical study in the 7-bed general intensive care unit of a university hospital.


SUBJECTS
Twenty-seven intubated adults who were deemed ready for extubation were enrolled.


MEASUREMENTS
Standard respiratory parameters and inspiratory muscle function data (ie, SMIP and peak maximal inspiratory pressures [MIP]) were recorded before extubation.


RESULTS
SMIP was found to be significantly greater in those who were successfully extubated than in those who underwent a failed extubation (P <.01). Receiver operating characteristic curves for SMIP data indicated that a cutoff point of 57.5 pressure time units would give a sensitivity and specificity of 1.0 for extubation outcome prediction. Peak MIP was also significantly greater in those successfully extubated (P =.04); a cutoff point of 17.5 cm H(2)O gave a sensitivity of 1.0 and a specificity of 0.5.


CONCLUSIONS
In this study, peak MIP was not specific enough to be clinically useful as a predictor of extubation outcome. SMIP was associated with extubation outcome with equally high sensitivity and specificity and may therefore have a role in outcome prediction.