ISSN:
1432-1238
Schlagwort(e):
Respiratory mechanics
;
Weaning prediction
;
COPD
Quelle:
Springer Online Journal Archives 1860-2000
Thema:
Medizin
Notizen:
Abstract Objective To assess in a group of COPD patients mechanically ventilated for an episode of acute respiratory failure the respiratory mechanics with a simple and non invasive method at the bedside in order to evaluate if these parameters may be predictive of weaning failure or success. Design A prospective study. Setting Intensive care and intermediate intensive care units. Patients 23 COPD patients ventilated for acute respiratory failure and studied within 24 hours from intubation. Methods Using end-expiratory and end-inspiratory airway occlusion technique, we measured PEEPi, static compliance of the respiratory system (Crs, st) maximum respiratory resistance (Rrsmax) and minimum respiratory resistance (Rrsmin). Measurements and results The weaned group (A) and the not weaned group (B) were not different regarding to static PEEPi (group A 8.5±4.0 vs group B 8.9±2.6 cmH2O), to Rrsmax (22.4±5.3 versus 22.2±9.0 cmH2O/l/s) and to Rrsmin (17.6±5.5 versus 17.9±8.0 cmH2O/l/s), while a significant difference (p〈0.001) has been found in Cst, rs (62.7±17.5 versus 111.6±18.0 ml/cm H2O). The threshold value of 88.5 ml/cmH2O was identified by discriminant analysis and provided the best separation between the two groups, with a sensitivity of 0.85 and a specificity of 0.87. Conclusion Cst, rs measured non invasively in the first 24 h from intubation, provided a good separation between the patients who were successfully weaned and those who failed.
Materialart:
Digitale Medien
URL:
http://dx.doi.org/10.1007/BF01707408
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