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September 17, 2025Open Access

Lower non-invasive estimated P mus predicts extubation failure in mechanically ventilated ICU patients

Key Points

Lower pre-SBT estimated inspiratory muscle pressure significantly predicts extubation failure in ICU patients.
Post-SBT estimated Pmus below 4.4 cmH₂O indicates a risk of extubation failure, with an AUC of approximately 0.73.
Respiratory muscle strength can be assessed using estimated Pmus as a simple bedside method for predicting extubation outcomes.
Further multicenter studies are necessary to validate the predictive value of estimated inspiratory muscle pressure.

Abstract

We evaluated whether non-invasive estimated inspiratory muscle pressure (Pmus) predicts extubation outcomes in ICU patients. Estimated Pmus, reflecting the pressure generated by respiratory muscles, was measured before and after the spontaneous breathing trial (SBT). Lower pre-SBT estimated Pmus (<4.1 cmH₂O) and post-SBT (<4.4 cmH₂O) were associated with extubation failure (AUC ≈ 0.73). P0.1 and dynamic transpulmonary pressure (PL,dyn) showed no significant association. Estimated Pmus offers a simple bedside method to assess inspiratory muscle strength and may help identify patients at risk of extubation failure. Further multicenter studies are needed to validate these findings.

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Cite This Study

Müller et al. (Tue,) studied this question.

synapsesocial.com/papers/68d4567431b076d99fa5bd9e https://doi.org/https://doi.org/10.1177/17511437251377989

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