ObjectiveTo evaluate whether a model of a daily fitness checklist for spontaneous
breathing tests is able to identify predictive variables of extubation
failure in pediatric patients admitted to a Brazilian intensive care
unit.MethodsThis was a single-center, cross-sectional study with prospective data
collection. The checklist model comprised 20 items and was applied to assess
the ability to perform spontaneous breathing tests.ResultsThe sample consisted of 126 pediatric patients (85 males (67.5%)) on invasive
mechanical ventilation, for whom 1,217 daily assessments were applied at the
bedside. The weighted total score of the prediction model showed the highest
discriminatory power for the spontaneous breathing test, with sensitivity
and specificity indices for fitness failure of 89.7% or success of 84.6%.
The cutoff point suggested by the checklist was 8, with a probability of
extubation failure less than 5%. Failure increased progressively with
increasing score, with a maximum probability of predicting extubation
failure of 85%.ConclusionThe extubation failure rate with the use of this model was within what is
acceptable in the literature. The daily checklist model for the spontaneous
breathing test was able to identify predictive variables of failure in the
extubation process in pediatric patients.