Chest
Clinical InvestigationsPrediction of Successful Ventilator Weaning Using Airway Occlusion Pressure and Hypercapnic Challenge
Section snippets
MATERIALS AND METHODS
We selected patients recovering from acute respiratory failure of a variety of medical and surgical etiologies, who were considered on clinical grounds to be ready for a weaning trial. All were clinically stable and afebrile for at least 24 hours before the study. During a brief trial of spontaneous ventilation, each could match the minute volume that was being delivered by the mechanical ventilator. The PaO2 was at least 75 mm Hg on Flo, of 0.50 or less, and arterial pH was less than 7.55 and
RESULTS
The 11 patients studied (eight men, three women) ranged in age from 32 to 73, mean 54 years. Etiologies of acute respiratory failure were chronic obstructive pulmonary disease (three patients), adult respiratory distress syndrome (two patients), drug overdose (three patients), flail chest (two patients), and sepsis (one patient). The duration of mechanical ventilation prior to study ranged from 1 to 193 days, with a mean of 58 days. Patients 1, 2, and 3 were restudied after 17, 24, and 14
DISCUSSION
This study demonstrates that in patients with a multitude of causes of respiratory failure, central respiratory drive, as measured by P0.1, was not significantly different between those patients who succeeded and those who failed to wean from mechanical ventilation. An examination of common predictors of successful weaning failed to find a predictor that was 100 percent sensitive and specific in this heterogeneous group. Surprisingly, though, bedside measurement of P0.1 during spontaneous
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The predictive value of airway occlusion pressure at 100 msec (P0.1) on successful weaning from mechanical ventilation: A systematic review and meta-analysis
2021, Journal of Critical CareCitation Excerpt :The basic features of the included studies are summarized in Table 1. The earliest article was published in 1987 [24], and the latest article was published in 2017 [20]. Five studies took place in Europe [25-29], 3 in North America [24,30,31], 2 in South America [20,32], and 2 in Asia [33,34].
What is the best way to wean and liberate patients from mechanical ventilation?
2019, Evidence-Based Practice of Critical CarePredictive factors of weaning from mechanical ventilation and extubation outcome: A systematic review
2018, Journal of Critical CareCitation Excerpt :It has also been reported that in patients with an age of 80 years or older, if the age is added to days of mechanical ventilation, a sum of 100 or more predicted a poor outcome [62]. Moreover, different studies [23,34,35] have demonstrated that the longer the duration (in days) of IMV, the lower the chance of success in weaning and extubating. It is known that mechanical ventilation causes rapid diaphragmatic wasting, weakening the very muscle strength required to generate an adequate tidal volume to supply the physiological needs of the body [63,64].
Monitoring the Airway and Pulmonary Function
2013, Benumof and Hagberg's Airway ManagementPrediction of extubation failure in medical intensive care unit patients
2012, Journal of Critical Care
Manuscript received June 5; revision accepted September 29.