Abstract
BACKGROUND:
Minute ventilation recovery time is a new predictor of extubation outcome that uses a subjective method for the determination of baseline minute ventilation (V̇E) during its measurement. The purpose of the current study is to evaluate the inter-rater reliability of this subjective method for determining baseline V̇E.
METHODS:
Three critical-care physicians served as independent readers. Each was trained with 5 practice V̇E trends, using the published method for determining baseline V̇E, defined as the lowest, stable nadir lasting 15–30 min prior to the final weaning trial before extubation. Readers then determined baseline V̇E prospectively from an 8-hour V̇E trend for 19 patients who were weaning from mechanical ventilation in the surgical intensive care unit of a tertiary care hospital. Each V̇E trend was an objective recording of V̇E every 15 min for 8 hours, immediately prior to the final weaning trial before extubation.
RESULTS:
There was excellent inter-rater reliability between trained readers for determination of a subjective V̇E baseline. Baseline V̇E was within 1 L/min for 15/19 patients (79%). Intra-class correlation across the 3 readers was 0.92 (p < 0.01). Tukey's test revealed no significant variability between readers (p > 0.5), and Spearman correlations between all reader pairs were significant (p < 0.01).
CONCLUSION:
After minimal training, readers can reliably determine a subjective baseline V̇E. This study validates the original methodology for determining baseline V̇E, an essential step in the measurement of minute ventilation recovery time.
Keywords
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