Clinical and Laboratory Parameters Monitored in Children Extubated from Ambu Bag and Endotracheal Tube

Abstract

Objective: To study the clinical and laboratory parameters of children extubated from ambu bag
and endotracheal tube after being manually ventilated for at least more than 24 hours.
Methods: Various clinical and laboratory parameters were evaluated initially at the time of
intubation and then at the time of extubation. The clinical parameters evaluated included the heart
rate & respiratory rate, Glasgow coma scale, spontaneous respiratory effort, respiratory distress
and pupillary reaction. The Laboratory parameters evaluated included TLC, CRP, arterial blood
pH, HCO3, PO2 & PCO2, CXR, flow rate of oxygen required to maintain oxygen saturation and
the dose of cardiac support in the form of dopamine infusion.
Results: Total 24 patients were included in the study, 11(46%) male and 13(54%) female. Age
range was from 0 to 36 months with mean of 6.5 months. The mean values of Laboratory
parameters at the time of intubation included a pH of 7.13, HCO3 17, O2 sat 64, PCO2 52, and
rate of oxygen flow 3.5 liters/min. The mean values of same parameters at the time of successful
weaning were, pH 7.36, HCO3 18, O2 sat 94, PCO2 29, and rate of flow of oxygen 3.5 liters/min.
Regarding clinical parameters the mean value for GCS at intubation was 5 which later improved
to 13 at extubation. Similarly the pupillary reaction at intubation showed constriction of pupils in
6(25%) and mid-dilated with sluggish reaction in remaining 18(75%), while almost 95% cases had
reactive pupils at extubation.
Conclusions: Ambu-bagging though crude but is a successful tool for respiratory support in the
absence of ventilator. Clinical and lab parameters can predict the outcome in children who are
solely intubated and ventilated by ambu bag