Document Detail


Evaluation of the Inspiratory Pressure Using a Digital Vacuometer in Mechanically Ventilated Patients: Analysis of the Time to Achieve the Inspiratory Peak.
MedLine Citation:
PMID:  21762557     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The measurement of the maximal inspiratory pressure (PImax) is of great importance in choosing the time for the start of weaning. OBJECTIVE: To measure the inspiratory pressure in mechanically ventilated patients suitable for weaning to determine the point at which the PImax is achieved along sixty seconds of observation, and analyze factors associated with PImax values. METHODS: Measurement of PImax was accomplished with a digital vacuometer with a unidirectional valve which only allows exhalation (PImaxUV). With this technique, values are registered and stored remaining accessible whenever necessary. All patients were on mechanical ventilation, and met the criteria recommended by the ATS/ERS 2007 to undergo weaning trial. RESULTS: Eighty-four from the 87 enrolled patients completed the test. No patient reached the PImaxUV in the first twenty seconds of observation. PImaxUV was achieved between 20.1 and 40 seconds in twelve patients (14.0%), and between 40.1 and 60 seconds in 72 cases (86.0%). In a multivariate analysis model in which age, gender, days of mechanical ventilation, APACHE score, and respiratory drive (P0.1) were included, only age (P=0.006) and P0.1 (P=0.003) were significantly associated with the values of PImaxUV. CONCLUSION: Within an observation period of 60 seconds, the majority of patients reached the maximal inspiratory peak between 40.1 and 60 seconds. Older patients were found to have lower PImaxUV values whereas higher values for P0.1 strongly correlated with higher PImaxUV values. Findings are potentially useful to improve successful weaning prediction in the future but further studies are needed to better clarify this issue.
Authors:
Leonardo Cordeiro de Souza; Cyro Teixeira da Silva; Jocemir Ronaldo Lugo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-12
Journal Detail:
Title:  Respiratory care     Volume:  -     ISSN:  0020-1324     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-18     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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