Document Detail


CO2 Response and Duration of Weaning From Mechanical Ventilation.
MedLine Citation:
PMID:  21496366     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: In mechanically ventilated patients ready for a spontaneous breathing trial, we investigated the relationship between CO₂ response and the duration of weaning. METHODS: CO₂ response test, and maximal inspiratory (MIP) and expiratory (MEP) pressure were evaluated in 102 non-consecutive ventilated patients. CO₂ response test measures the hypercapnic drive response (HCDR), defined as the ratio of the change in occlusion pressure (P0.1) to the change in PaCO₂ (_PaCO₂), and the hypercapnic ventilatory response (HCVR), defined as the ratio of the change in minute volume to _PaCO₂. Patients were categorized as having prolonged weaning when duration of weaning was > 7 days and non-prolonged when weaning was ≤ 7 days. Results Twenty-seven patients had prolonged weaning. Between prolonged and non-prolonged weaning groups we found differences in HCDR (0.22±0.16 and 0.47±0.22 cm H₂O/mm Hg respectively; p <0.001) and HCVR (0.25±0.23 and 0.53±0.33 L/min/mm Hg respectively; p <0.001). The optimal cut-off point to differentiate between prolonged and non-prolonged weaning was for HCDR 0.19 cm H₂O/mm Hg and for HCVR 0.15 L/min/mm Hg. Independent variables associated with the duration of weaning studied using Cox proportional hazard model were the HCDR and HCVR. The hazard ratio of weaning success were 16.7 times higher if HCDR was >0.19 cm H₂O/mm Hg and 6.3 times higher if HCVR was >0.15 L/min/mm Hg. Other variables, including P0.1, MIP and MEP were not associated with the duration of the weaning. CONCLUSION: Decreased CO₂ response, measured by the hypercapnic drive response and the ventilatory response, was associated with prolonged weaning.
Authors:
Joan Maria Raurich; Gemma Rialp; Jordi Ibáñez; Joan Antoni Llompart-Pou; Ignacio Ayestarán
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-15
Journal Detail:
Title:  Respiratory care     Volume:  -     ISSN:  0020-1324     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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