Document Detail


Respiratory Muscle Assessment in Predicting Extubation Outcome in Patients With Stroke.
MedLine Citation:
PMID:  22494544     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Patients with cerebral infarction often present impaired consciousness and unsatisfactory extubation. We aimed to assess the respiratory mechanics components that might be associated with the success of extubation in stroke patients. METHODS: Twenty consecutive patients with stroke who needed mechanical ventilation support were enrolled. The maximal inspiratory pressure, gastric and the esophageal pressure (Pdi/Pdimax), minute volume, respiratory rate, static compliance, airway resistance, rapid and superficial respiration index (RSRI), inspiratory time/total respiratory cycle (Ti/Ttot), and PaO(2)/FiO(2) were measured. RESULTS: The group who presented success to the extubation process presented 12.5±2.2 days in mechanical ventilation and the group who failed presented 13.1±2 days. The mean Ti/Ttot and Pdi/Pdimax for the failure group was 0.4±0.08 (0.36-0.44) and 0.5±0.7 (0.43-0.56), respectively. The Ti/Ttot ratio was 0.37±0.05 (0.34-0.41, p=0.0008) and the Pdi/Pdimax was 0.25±0.05 for the success group (0.21-0.28, p<0.0001). A correlation was found between Pdi/Pdimax ratio and the RSRI (r=0.55, p=0.009) and PaO(2)/FiO(2) (r=-0.59, p=0.005). Patients who presented a high RSRI (OR 3.66, p=0.004) and Pdi (OR 7.3, p=0.002); and low PaO(2)/FIO(2) (OR 4.09, p=0.007), Pdi/Pdimax (OR 4.12, p=0.002) and RAW (OR 3.0, p=0.02) developed mechanical ventilation extubation failure. CONCLUSION: Muscular fatigue index is an important predicting variable to the extubation process in prolonged mechanical ventilation of stroke patients.
Authors:
Antonio A M Castro; Felipe Cortopassi; Russell Sabbag; Luis Torre-Bouscoulet; Claudia Kümpel; Elias Ferreira Porto
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-9
Journal Detail:
Title:  Archivos de bronconeumologia     Volume:  -     ISSN:  1579-2129     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0354720     Medline TA:  Arch Bronconeumol     Country:  -    
Other Details:
Languages:  ENG; SPA     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.
Affiliation:
Respiratory Diseases Department, Federal University of São Paulo and Adventist University, Rua Cônego Eugênio Leite, 632, Pinheiros, 05414000 São Paulo, SP, Brazil; Federal University of Pampa (Unipampa), Rio Grande do Sul, Brazil.
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