| Increase in plasma protein concentration for diagnosing weaning-induced pulmonary oedema. | |
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MedLine Citation:
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PMID: 18297263 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Weaning-induced cardiogenic pulmonary oedema is a cause of weaning failure that is classically diagnosed by an increase in pulmonary artery occlusion pressure during a spontaneous breathing trial. During cardiogenic pulmonary oedema, a hypo-oncotic fluid is filtered toward the interstitial space. Thus, we tested whether the changes in plasma protein concentration during a weaning trial could diagnose weaning-induced pulmonary oedema. DESIGN: Prospective study. SETTING: The 24-bed medical intensive care unit of a university hospital. PATIENTS: Forty-six patients who had failed two weaning trials. INTERVENTION: Weaning-induced pulmonary oedema was diagnosed if a respiratory failure associated with an increase in pulmonary artery occlusion pressure above 18 mmHg occurred during a third weaning trial on a T-tube. The plasma protein concentration was measured before and at the end of the spontaneous breathing trial. MEASUREMENTS AND RESULTS: During the weaning trial, pulmonary oedema was observed in 24 patients. In these patients, the plasma protein concentration increased by 11% (3-25%). The plasma protein concentration did not change significantly in patients who did not experience weaning-induced pulmonary oedema. An increase in the plasma protein concentration greater than 6% from baseline to the end of the weaning trial allowed detecting a weaning-induced pulmonary oedema with a sensitivity of 87% and a specificity of 95%. CONCLUSION: The acute changes in plasma protein concentration during a weaning trial represent an alternative method to right heart catheterisation for assessing weaning-induced pulmonary oedema. |
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Authors:
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Nadia Anguel; Xavier Monnet; David Osman; Vincent Castelain; Christian Richard; Jean-Louis Teboul |
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Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2008-02-23 |
Journal Detail:
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Title: Intensive care medicine Volume: 34 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-06-25 Completed Date: 2008-12-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1231-8 Citation Subset: IM |
Affiliation:
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Service de réanimation médicale, Centre Hospitalier Universitaire de Bicêtre, AP-HP, 94 270, Le Kremlin-Bicêtre, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Blood Proteins / diagnostic use, metabolism* Hemodynamics Humans Middle Aged Pulmonary Edema / blood, diagnosis, etiology* ROC Curve Ventilator Weaning / adverse effects* |
| Chemical | |
Reg. No./Substance:
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0/Blood Proteins |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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