Keywords
Ventilación mecánica
Índice de Tobin
Insuficiencia respiratoria
Unidad de cuidados intensivos. Extubation
Mechanical ventilation
Tobin Index
Respiratory failure
Intensive care unit
How to Cite
Abstract
Introduction. Extubation failure is defined as the need for reintubation within 48-72 hours after planned extubation. Failed extubation is associated with prolonged mechanical ventilation and high mortality rates. Although the Tobin Index has been validated as a predictor of extubation success, its specific utility in high-risk patients has not been correlated with other clinical variables. Objective. To determine the relationship between the Tobin Index and clinical and sociodemographic variables in ventilated patients at high risk of extubation failure. Methods. Prospective observational study. Critically ill patients with invasive mechanical ventilation for more than 48 hours and considered high risk for extubation failure were included. Demographic and clinical variables were evaluated. Correlations and Kruskal-Wallis tests were performed. Results. A total of 40 patients with an average age of 57,02 years were included. There was a significant difference in the Tobin Index between men and women (median of 35 vs 40,5) (p = 0,012), and a significant positive correlation between the APACHE II score and the Tobin Index (Spearman's Rho: 1, p < 0,0001). None of the patients experienced extubation failure. Discussion. This study provides evidence on the utility of the Tobin Index defined by clinical, paraclinical, and ventilatory variables. The significant correlation between the Tobin Index and the APACHE II score suggests that a higher index may be related to greater disease severity, which is crucial for predicting and preventing extubation failure in this high-risk population.
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