Changes in albuminuria during the spontaneous breathing trial: A prospective observational study.


Journal

Journal of the Formosan Medical Association = Taiwan yi zhi
ISSN: 0929-6646
Titre abrégé: J Formos Med Assoc
Pays: Singapore
ID NLM: 9214933

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 19 11 2018
revised: 11 06 2019
accepted: 04 07 2019
pubmed: 22 7 2019
medline: 3 11 2020
entrez: 21 7 2019
Statut: ppublish

Résumé

We hypothesized urine albumin concentration may detect the early increasing cardiac load during the spontaneous breathing trial (SBT). The purpose of our study is to determine whether the changes in urine albumin concentration before and after the SBT correlate with SBT outcome. This prospective observational study was conducted from January 2013 to September 2013. Patients receiving endotracheal tube intubation due to acute respiratory failure were included. Urine albumin concentration was measured upon admission to the intensive care unit, before and after the SBT. A total of 211 patients with respiratory failure were screened. Finally, 69 patients were included for analysis. Among the 69 patients received the SBT, 61 patients passed the SBT while 8 patients didn't. Urine albumin concentration upon admission was 251.00 ± 108.21 mg/g in the SBT success group and 260.87 ± 77.95 mg/g in the SBT failure group (p = 0.97). The mean percent change in urine albumin concentration during the SBT was significantly higher in the SBT failure group (+58.44%) than in the SBT success group (+13.11%) (p = 0.02). Univariable and multivariable logistic regression model showed that the difference of urine albumin concentration before and after the SBT correlated significantly with SBT failure (adjusted OR:1.04, p = 0.01). This open label pilot study demonstrates the significant association of the changes in urine albumin concentration with SBT outcome. Further study is warranted to investigate the predictive value of urine albumin concentration.

Sections du résumé

BACKGROUND BACKGROUND
We hypothesized urine albumin concentration may detect the early increasing cardiac load during the spontaneous breathing trial (SBT). The purpose of our study is to determine whether the changes in urine albumin concentration before and after the SBT correlate with SBT outcome.
METHODS METHODS
This prospective observational study was conducted from January 2013 to September 2013. Patients receiving endotracheal tube intubation due to acute respiratory failure were included. Urine albumin concentration was measured upon admission to the intensive care unit, before and after the SBT.
RESULTS RESULTS
A total of 211 patients with respiratory failure were screened. Finally, 69 patients were included for analysis. Among the 69 patients received the SBT, 61 patients passed the SBT while 8 patients didn't. Urine albumin concentration upon admission was 251.00 ± 108.21 mg/g in the SBT success group and 260.87 ± 77.95 mg/g in the SBT failure group (p = 0.97). The mean percent change in urine albumin concentration during the SBT was significantly higher in the SBT failure group (+58.44%) than in the SBT success group (+13.11%) (p = 0.02). Univariable and multivariable logistic regression model showed that the difference of urine albumin concentration before and after the SBT correlated significantly with SBT failure (adjusted OR:1.04, p = 0.01).
CONCLUSION CONCLUSIONS
This open label pilot study demonstrates the significant association of the changes in urine albumin concentration with SBT outcome. Further study is warranted to investigate the predictive value of urine albumin concentration.

Identifiants

pubmed: 31324438
pii: S0929-6646(18)30806-4
doi: 10.1016/j.jfma.2019.07.006
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

488-495

Informations de copyright

Copyright © 2019 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

Auteurs

You-Yi Chen (YY)

Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Douliou, Taiwan.

Jih-Shuin Jerng (JS)

Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Jien-Jiun Chen (JJ)

Cardiovascular Center, National Taiwan University Hospital, Yun-Lin Branch, Douliou, Taiwan.

Fan-Chi Chang (FC)

Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Yao-Wen Kuo (YW)

Department of Integrated Diagnostics & Therapeutics, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: kyw@ntu.edu.tw.

Hao-Chien Wang (HC)

Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Huey-Dong Wu (HD)

Department of Integrated Diagnostics & Therapeutics, National Taiwan University Hospital, Taipei, Taiwan.

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