We used decision analysis to determine the factors that influence the decision of whether or not to extubate and to evaluate the usefulness of testing with the RR/Vt ratio. A questionnaire was also distributed to experienced critical care specialists. We showed that the rate of improvement in the patient condition had the greatest influence on the decision to extubate. When the rate of improvement was high, the best decision was to continue with mechanical ventilation unless the probability of tolerating extubation was greater than 0.95. However, when there was little or no chance of further improvement with ongoing mechanical ventilation, the best decision was always to extubate. These results appeared to be counter-intuitive to experienced clinicians who were more likely to extubate when patients were improving and less likely when patients were stable. Testing with the RR/Vt ratio was of little benefit when deciding to extubate.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.31203 |
| Date | January 2001 |
| Creators | Cardinal, Pierre. |
| Contributors | Hutchinson, Thomas (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001802173, proquestno: MQ70392, Theses scanned by UMI/ProQuest. |
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