The predictive value of neurally adjusted ventilatory assist indexes for the outcome of patients with severe hemorrhagic stroke

Abstract

Abstract Objective: This study assessed the predictive value of electrical activity of the diaphragm (EAdi) and the EAdi-derived monitoring index in the outcome of patients with severe hemorrhagic stroke. Methods: Ninety patients with severe hemorrhagic stroke were admitted to the neurosurgery intensive care unit of Yijishan Hospital from April 2019 to June 2021 and were divided into the good outcome group (Glasgow Outcome Scale [GOS] ≥4) and poor outcome group [GOS]≤3). The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate prediction accuracy. Results: EAdi, neuro-ventilatory efficiency (NVE), and neuro-muscular efficiency (NME) in patients with good outcome were significantly higher than those in patients with poor outcome (4.707 µV vs 2.80 µV, P < 0.001; 141.85 ml/µV vs 66.01 ml/µV, P = 0.000; 2.57 cm H2O/µV vs 1.37 cm H2O/µV, P = 0.000). The area under the ROC curve for the EAdi score was 0.719, with sensitivity of 69.70% and specificity of 68.42% when EAdi was 3.6 µV. The AUC for NVE score was 0.793, with sensitivity of 75.76% and specificity of 77.19% when the NVE value was 95.32 ml/µV. The AUC for NME score was 0.792, with sensitivity of 69.70% and specificity of 78.95% when the NME value was 2.06 H2O/µV. The 6-month survival time of patients with higher EAdi, NVE, and NME was significantly longer than that of patients with lower EAdi, NVE, and NME. Conclusion: EAdi, NVE, and NME can be used as indices for predicting the outcome of patients with severe hemorrhagic stroke. Trial registration: No.ChiCTR1900022861. Registered April 28, 2016, http:// www.chictr.org.cn