Document Detail

Elevated static compliance of the total respiratory system: early predictor of weaning unsuccess in severed COPD patients mechanically ventilated.
MedLine Citation:
PMID:  7665749     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess in a group of COPD patients mechanically ventilated for an episode of acute respiratory failure the respiratory mechanics with a simple and non invasive method at the bedside in order to evaluate if these parameters may be predictive of weaning failure or success.
DESIGN: A prospective study.
SETTING: Intensive care and intermediate intensive care units.
PATIENTS: 23 COPD patients ventilated for acute respiratory failure and studied within 24 hours from intubation.
METHODS: Using end-expiratory and end-inspiratory airway occlusion technique, we measured PEEPi, static compliance of the respiratory system (Crs, st) maximum respiratory resistance (Rrsmax) and minimum respiratory resistance (Rrsmin).
MEASUREMENTS AND RESULTS: The weaned group (A) and the not weaned group (B) were not different regarding to static PEEPi (group A 8.5 +/- 4.0 vs group B 8.9 +/- 2.6 cmH2O), TO Rrsmax (22.4 +/- 5.3 versus 22.2 +/- 9.0 cmH2O/1/s) and to Rrsmin (17.6 +/- 5.5 versus 17.9 +/- 8.0 cmH2O/1/s), while a significant difference (p < 0.001) has been found in Cst, rs (62.7 +/- 17.% versus 111.6 +/- 18.0 ml/cm H2O). The threshold value of 88.5 ml/cmH2O was identified by discriminant analysis and provided the best separation between the two groups, with a sensitivity of 0.85 and a specificity of 0.87.
CONCLUSION: Cst, rs measured non invasively in the first 24 h from intubation, provided a good separation between the patients who were successfully weaned and those who failed.
E Zanotti; F Rubini; G Iotti; A Braschi; A Palo; C Bruschi; C Fracchia; S Nava
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  21     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1995 May 
Date Detail:
Created Date:  1995-10-12     Completed Date:  1995-10-12     Revised Date:  2014-07-29    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  399-405     Citation Subset:  IM    
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MeSH Terms
Acute Disease
Airway Resistance
Discriminant Analysis
Lung Compliance*
Lung Diseases, Obstructive / complications*
Middle Aged
Positive-Pressure Respiration, Intrinsic / diagnosis
Predictive Value of Tests
Prospective Studies
Respiratory Insufficiency / etiology,  physiopathology,  therapy*
Treatment Failure
Ventilator Weaning*

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

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