Document Detail


Assessment of diaphragmatic function with cervical magnetic stimulation in critically ill patients.
MedLine Citation:
PMID:  16119490     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to evaluate a non-volitional measurement to assess diaphragmatic function in intubated and mechanically ventilated patients in a prospective pilot interventional clinical trial. The study was conducted in an 18-bed postoperative intensive care unit based at a university hospital. Patients were prospectively assigned to two groups. Group 1 consisted of eight patients with ventilator weaning failure. Group 2 consisted of eight intubated and ventilated patients who were studied shortly after major surgery and were successfully extubated there-after The twitch pressure response after cervical magnetic stimulation of the phrenic nerves was measured at the endotracheal tube at different PEEP levels. In group 2 the twitch transdiaphragmatic pressure, defined as the difference between twitch gastric and twitch oesophageal pressure was also evaluated. In group 1 the mean twitch pressure at the endotracheal tube on PEEP 0, 5 and 10 cmH2O was 5.2, 4.5 and 2.6 cmH2O: In group 2 this was significantly higher (15.1 cmH2O on PEEP 0 and 12.2 cmH2O on PEEP 5). A good correlation was found between twitch diaphragmatic pressure and twitch pressure at the endotracheal tube (r2 = 0.96) and between twitch oesophageal pressure and twitch pressure at the endotracheal tube (r2 = 0.98). Patients with weaning failure have significantly lower twitch pressure at the endotracheal tube suggesting diaphragmatic dysfunction. Twitch pressure at the endotracheal tube may be a useful parameter to screen for diaphragmatic dysfunction in intubated critically ill patients. Further studies are needed to confirm these preliminary findings.
Authors:
H Buscher; P Valta; T Boie; J Hinz; O Moerer; M Sydow; M Y Mudaliar; H Burchardi
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  33     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-25     Completed Date:  2006-02-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  483-91     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Emergency Medicine and Intensive Care, University of Göttingen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cervical Plexus / physiology*
Critical Illness
Diaphragm / innervation,  physiopathology*
Humans
Intubation, Intratracheal / methods
Magnetics*
Middle Aged
Phrenic Nerve / physiology
Physical Stimulation / methods*
Pilot Projects
Positive-Pressure Respiration / methods
Prospective Studies
Respiration, Artificial / methods
Respiratory Function Tests / methods*
Respiratory Muscles / physiopathology
Time Factors
Ventilator Weaning / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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