Efficacy of echocardiography during spontaneous breathing trial with low‐level pressure support for predicting weaning failure among medical critically ill patients

2019 ◽  
Vol 36 (4) ◽  
pp. 659-665 ◽  
Author(s):  
Surat Tongyoo ◽  
Preecha Thomrongpairoj ◽  
Chairat Permpikul
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Spontaneous Breathing ◽  
Pressure Support ◽  
Spontaneous Breathing Trial ◽  
Low Level ◽  
Level Pressure ◽  
Weaning Failure

Spontaneous breathing trial in T-tube negatively impact on autonomic modulation of heart rate compared with pressure support in critically ill patients

2015 ◽  
Vol 11 (4) ◽  
pp. 489-495 ◽  
Author(s):  
Adriana M. Güntzel Chiappa ◽  
Gaspar R. Chiappa ◽  
Gerson Cipriano ◽  
Ruy S. Moraes ◽  
Elton L Ferlin ◽  
...  
Keyword(s):  
Heart Rate ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Spontaneous Breathing ◽  
Pressure Support ◽  
Spontaneous Breathing Trial ◽  
Autonomic Modulation ◽  
T Tube

scholarly journals Exploration of Diaphragm Excursion Inflection Point in Predicting Weaning From Mechanical Ventilation in Critically Ill Patients: An Observational Study

2021 ◽  
Author(s):  
Zhijing Zhu ◽  
Yongxing Wu ◽  
Jiyu Bai ◽  
XingQing Zhu ◽  
Yanan Gu
Keyword(s):  
Mechanical Ventilation ◽  
Success Rate ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Spontaneous Breathing ◽  
Inflection Point ◽  
Pressure Support ◽  
Deep Breathing ◽  
Weaning From Mechanical Ventilation ◽  
Chi Square

Abstract ObjectivePressure-supported ventilation is widely used in critically ill patients, and the patient's effort in spontaneous breathing is an important predictor of the success rate of weaning, but this index is difficult to measure accurately under clinical conditions. It has been demonstrated that the absolute value of diaphragm excursion is influenced by multiple factors and cannot be used as a predictor of weaning from mechanical ventilation. This study aims to reveal the characteristics of diaphragm excursion changes (respiratory excursion) at different levels of pressure support, and explore whether it can predict the weaning from mechanical ventilation.DesignProspective cohort study.SettingSingle-center.PatientsPatients admitted to the ICU who were mechanically ventilated and had met the criteria to perform an autonomic breathing test were enrolled. Patients with tracheal obstruction or after thoracic/gastric/esophageal surgery were excluded. InterventionsDifferent levels of pressure support (20,15,10,5 and 0 cm H2O) were applied in pressure-assisted ventilation mode, and the effort of each patient's inspiratory muscles at different support levels was observed by B- and M-mode ultrasonography to assess right side diaphragm mobility. Measurements and Main ResultsRespiratory mechanics parameters under deep/calm breathing, dynamic changes in diaphragm movement, diaphragm excursion inflection points and whether the patients were successfully deconditioned were recorded. Forty-one patients were enrolled, and the results showed that 78.6% (22/28) of patients with a deep breathing inflection point of 10 cmH2O (nadir of 5 cmH2O) and 33.3% (4/12) of patients with a deep breathing inflection point of 15 cmH2O (nadir of 10 cmH2O) successfully weaned from mechanical ventilation, with the former having a significantly higher rate than the latter. The success rate was statistically significant (Chi-square=7.556 P=0.006); 77.8% (21/27) of patients with calm breathing inflection point of 10 cmH2O (lowest point of 5 cmH2O) and 38.5% (5/13) of patients with calm breathing inflection point of 15 cmH2O (lowest point of 10 cmH2O). 13), the former had a statistically significant higher off-boarding success rate than the latter (Chi-square=5.962 P=0.0146).ConclusionsIn the process of weaning from mechanical ventilation patients, when performing a spontaneous breathing test, the right diaphragm excursion inflection point during deep/calm breathing can be measured by ultrasound to assess the patient's spontaneous breathing effort component, and this study found that the weaning success rate was lower in the group with an inflection point of 15 cm H2O than in the group with an inflection point of 10 cm H2O, so the diaphragm excursion inflection point may be a reliable indicator to predict the deconditioning success.

scholarly journals Spontaneous breathing trial and post-extubation work of breathing in morbidly obese critically ill patients

Critical Care ◽  
2016 ◽  
Vol 20 (1) ◽  
Author(s):  
Martin Mahul ◽  
Boris Jung ◽  
Fabrice Galia ◽  
Nicolas Molinari ◽  
Audrey de Jong ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Spontaneous Breathing ◽  
Work Of Breathing ◽  
Spontaneous Breathing Trial ◽  
Morbidly Obese
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