Shen et al identified factors predictive of the duration of mechanical ventilation in a patient with carbon monoxide poisoning. The authors are from National Defense Medical Center in Taipei.
Patient selection: acute respiratory failure associated with severe carbon monoxide poisoning
Initial management: endotracheal intubation and mechanical ventilation
Parameters for of early extubation (less than 72 hours):
(1) toxicologic drug screen
(2) serum troponin I level on admission to ED
Parameter
Finding
Points
toxicologic screen
negative
0
positive
1
serum troponin I
normal
1
elevated
0
where:
• An elevated troponin I level was associated with prolonged ventilation.
number of factors associated with early extubation =
= SUM(points for the 2 parameters)
Interpretation:
• minimum score: 0
• maximum score: 2
• A patient with a score of 2 was more likely to have an early extubation.
Score
Early Extubation
0
unlikely
1
uncertain
2
likely
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