Document Detail


Respiratory impedance during weaning from mechanical ventilation in a mixed population of critically ill patients.
MedLine Citation:
PMID:  19887532     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Worsening of respiratory mechanics during a spontaneous breathing trial (SBT) has been traditionally associated with weaning failure, although this finding is based on studies with chronic obstructive pulmonary disease patients only. The aim of our study was to assess the course of respiratory impedance non-invasively measured by forced oscillation technique (FOT) during a successful and failed SBT in a mixed population. METHODS: Thirty-four weaning trials were reported in 29 consecutive mechanically ventilated patients with different causes of initiation of ventilation. During the SBT, the patient was breathing through a conventional T-piece connected to the tracheal tube. FOT (5 Hz, +/- 1 cm H(2)O, 30 s) was applied at 5, 10, 15, 20, 25, and 30 min. Respiratory resistance (Rrs) and reactance (Xrs) were computed from pressure and flow measurements. The frequency to tidal volume ratio f/V(t) was obtained from the flow signal. At the end of the trial, patients were divided into two groups: SBT success and failure. RESULTS: Mixed model analysis showed no significant differences in Rrs and Xrs over the course of the SBT, or between the success (n=16) and the failure (n=18) groups. In contrast, f/V(t) was significantly (P<0.001) higher in the failure group. CONCLUSIONS: Worsening of respiratory impedance measured by FOT is not a common finding during a failed SBT in a typically heterogeneous intensive care unit population of mechanically ventilated patients.
Authors:
J Sellares; I Acerbi; H Loureiro; R L Dellaca; M Ferrer; A Torres; D Navajas; R Farre
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-11-03
Journal Detail:
Title:  British journal of anaesthesia     Volume:  103     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-17     Completed Date:  2009-12-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  828-32     Citation Subset:  IM    
Affiliation:
Servicio de Neumología, Instituto Clínico del Tórax, Hospital Clínic de Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona (UB), Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Aged
Airway Resistance / physiology*
Critical Illness / therapy*
Female
Humans
Inhalation / physiology
Intensive Care / methods
Male
Oscillometry / methods
Prospective Studies
Respiratory Function Tests / methods
Tidal Volume
Treatment Failure
Ventilator Weaning*

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


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