Heart Rate, Acidosis, Consciousness, Oxygenation, and Respiratory Rate: A Perfect Weaning Index or Just a New Kid on the Block
Difficult weaning, Heart rate, acidosis, consciousness, oxygenation, and respiratory rate score, Weaning from mechanical ventilation, Weaning predictors
Citation Information :
Sharma J. Heart Rate, Acidosis, Consciousness, Oxygenation, and Respiratory Rate: A Perfect Weaning Index or Just a New Kid on the Block. Indian J Crit Care Med 2022; 26 (8):887-888.
Successful weaning is when spontaneous breathing is sustained for more than 48 hours after extubation. Despite a plethora of individual and composite weaning indices being available, most indices have not found much clinical utility, and weaning continues to be largely based on clinical assessment. Heart rate, acidosis, consciousness, oxygenation, and respiratory rate (HACOR) is a new score for prediction of failure of noninvasive ventilation (NIV) in hypoxemic patients receiving NIV. The present study explores its utilization in weaning from invasive ventilation.
Boles J-M, Bion J, Connors A, Herridge M, Marsh B, Melot C, et al. Weaning from mechanical ventilation. Eur Respir J 2007;29(5): 1033–1056. DOI: 10.1183/09031936.00010206.
Macintyre NR. Evidence-based assessments in the ventilator discontinuation process. Respir Care 2012;57(10):1611–1618. DOI: 10.4187/respcare.02055.
Thille AW, Harrois A, Schortgen F, Brun-Buisson C, Brochard L. Outcomes of extubation failure in medical intensive care unit patients. Crit Care Med 2011;39(12):2612–2618. DOI: 10.1097/CCM. 0b013e3182282a5a.
Nemer SN, Barbas CSV, Caldeira JB, Guimarães B, Azeredo LM, Gago R, et al. Evaluation of maximal inspiratory pressure tracheal occlusion airway pressure, and its ratio in the weaning outcome. J Crit Care 2009;24(3):441–446. DOI: 10.1016/j.jcrc.2009.01.007.
Yang KL, Tomin MJ. A Prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med 1991;324(21):1445–1450. DOI: 10.1056/NEJM199105233242101.
Nemer SN, Barbas CSV, Caldeira JB, Cárias TCM, Santos RG, Almeida LC, et al. A new integrative weaning index of discontinuation from mechanical ventilation. Crit Care 2009;13(5):R152. DOI: 10.1186/cc8051.
Delisle S, Francoeur M, Albert M, Ouellet P, Bellemare P, Arsenault P. Respir Care 2011;56(10):1500–1505. DOI: 10.4187/respcare.00768.
Duan J, Han X, Bai L, Zhou L, Huang S. Assessment of heart rate, acidosis, consciousness, oxygenation and respiratory rate to predict non-invasive ventilation failure in hypoxemic patients. Intensive Care Med 2017;43(2):192–199. DOI: 10.1007/s00134-016-4601-3.
Ding M, Han X, Bai L, Huang S, Duan J. Impact of HACOR score in non-invasive ventilation failure in 148 non-COPD patients with acute non-chronic respiratory failure. Can Respir J 2021:9960667. DOI: 10.1155/2021/9960667.
Guia MF, Boleo-Tome JP, Imitazione P, Polistina GE, Alves C, Ishikawa O, et al. Usefulness of HACOR score in prediction success of CPAP in COVID-19 related hypoxemia. Respir Med 2021;187:106550. DOI: 10.1016/j.rmed.2021.106550.
Bai L, Ding F, Xiong W, Shu W, Jiang L, Liu Y, et al. Early assessment of the efficacy of non-invasive ventilation tested by HCAOR score to avoid delayed intubation in patients with moderate to severe ARDS. Ther Adv Respir Dis 2022;16:17534666221081042. DOI: 10.1177/17534666211081042.
Chaudhuri S, Gupta N, Adhikari SD, Todur P, Maddani SS, Rao S. Utility of the one-time HACOR score as a predictor of weaning failure from mechanical ventilation: A prospective observational study. Indian J Crit Care Med 2022;26(8):900–905.
Duan J, Chen L, Liu X, Bozbay S, Liu Y, Wang K, et al. An updated HACOR score for predicting the failure of noninvasive ventilation: a multicenter prospective, observational study. Crit Care 2022;26:196. DOI: 10.1186/s13054-022-04060-7.