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Work of breathing during successful spontaneous breathing trial.
MedLine Citation:
PMID:  19327319     Owner:  NLM     Status:  In-Process    
OBJECTIVE: The aim of this study was to evaluate the work of breathing (WOB) behavior during a 120-minute successful spontaneous breathing trial (SBT) with T-tube trial, and its predictive value for extubation outcome. DESIGN: A prospective cohort study. SETTING: 2 medical-surgical intensive care units. PATIENTS: Fifty-one consecutive patients mechanically ventilated for more than 48 hours after a successful SBT were extubated based on the institutional protocol and followed for the occurrence of postextubation respiratory distress during 48 hours. MEASUREMENTS AND MAIN RESULTS: All cases were serially monitored during 120 minutes of SBT using the respiratory monitoring system Ventrak 1500 (Medical Novametrix Systems, Wallingford, CT). Successful extubation occurred in 38 (74.5%) of 51 of the sample. Respiratory and hemodynamic parameters, APACHE II score, sex, days on mechanical ventilation, and cause of respiratory failure were unable to predict extubation outcome. The WOB significantly increased during SBT in extubation failure patients (WOB at 1st minute 0.24 +/- 0.06 J/L vs WOB at 120th minute = 0.39 +/- 0.07 J/L; P < .01) when compared to successfully extubated patients (WOB at 1st minute 0.21 +/- 0.08 J/L vs WOB at 120th minute = 0.24 +/- 0.11 J/L; P = .12). The WOB variation was able to predict extubation outcome only after the 90th minute of SBT (extubation failure = 0.35 +/- 0.08 J/L vs extubation success = 0.22 +/- 0.11 J/L; P = .01). CONCLUSION: An increase in the WOB could predict extubation failure during a T-tube trial of 120 minutes.
Cassiano Teixeira; Paulo José Zimermann Teixeira; Patrícia Pickersgill de Leon; Eubrando Silvestre Oliveira
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Publication Detail:
Type:  Journal Article     Date:  2009-02-13
Journal Detail:
Title:  Journal of critical care     Volume:  24     ISSN:  1557-8615     ISO Abbreviation:  J Crit Care     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610642     Medline TA:  J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  508-14     Citation Subset:  IM    
Pavilhão Pereira Filho Respiratory Intensive Care Unit, Complexo Hospitalar da Santa Casa, Porto Alegre, Brasil.
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