%0 Journal Article
%T Peripheral perfusion index as a predictor of reintubation in critically ill surgical patients.
%A Abougabal A
%A Hasanin A
%A Abdel-Fatah M
%A Mostafa M
%A Ismail AA
%A Habib S
%J BMC Anesthesiol
%V 24
%N 1
%D 2024 Jul 9
%M 38982350
%F 2.376
%R 10.1186/s12871-024-02608-4
%X <B>OBJECTIVE: </B>We aimed to evaluate the ability of the peripheral perfusion index (PPI) to predict reintubation of critically ill surgical patients.<BR><B>METHODS: </B>This prospective observational study included mechanically ventilated adults who were extubated after a successful spontaneous breathing trial (SBT). The patients were followed up for the next 48 h for the need for reintubation. The heart rate, systolic blood pressure, respiratory rate, peripheral arterial oxygen saturation (SpO2), and PPI were measured before-, at the end of SBT, 1 and 2 h postextubation. The primary outcome was the ability of PPI 1 h postextubation to predict reintubation using area under the receiver operating characteristic curve (AUC) analysis. Univariate and multivariate analyses were performed to identify predictors for reintubation.<BR><B>RESULTS: </B>Data from 62 patients were analysed. Reintubation occurred in 12/62 (19%) of the patients. Reintubated patients had higher heart rate and respiratory rate; and lower SpO2 and PPI than successfully weaned patients. The AUC (95%confidence interval) for the ability of PPI at 1 h postextubation to predict reintubation was 0.82 (0.71-0.91) with a negative predictive value of 97%, at a cutoff value of ≤ 2.5. Low PPI and high respiratory rate were the independent predictors for reintubation.<BR><B>CONCLUSIONS: </B>PPI early after extubation is a useful tool for prediction of reintubation. Low PPI is an independent risk factor for reintubation. A PPI > 2.5, one hour after extubation can confirm successful extubation.