|Title:||Comparison of physiological responses to spontaneous breathing trials with a T-tube and low-level pressure support||Authors:||SHENG-YUAN RUAN
|Issue Date:||2013||Publisher:||Australian Society of Anaesthetists||Journal Volume:||41||Journal Issue:||1||Start page/Pages:||41-45||Source:||Anaesthesia and Intensive Care||Abstract:||
Previous studies have shown that spontaneous breathing trials (SBT) with a T-tube or low-level pressure support are comparable. However, low-level pressure support may overestimate the ability of a patient to sustain spontaneous breathing, resulting in premature extubation. Understanding factors contributing to different responses by patients to the two SBT methods aids in clarifying the limitation of using low-level pressure support for SBT. We performed a prospective observational study in 80 consecutive adult patients with mechanical ventilation to identify the factors contributing to different responses of a patient to the two SBT methods. The 80 patients underwent both a T-tube trial and pressure support ventilation of 6 cmH2O (PS-6) on the day of extubation. Stratified analysis was used to evaluate the effects of age, respiratory compliance and resistance, PaO2/FiO2 ratio and underlying disease on post-SBT responses. Comparing the responses to a T-tube trial and PS-6, the patients with old age, poor pulmonary compliance (?40 ml/cmH2O) and chronic obstructive pulmonary disease had a higher heart rate (difference [95% CI]: 4 [0,8], 5 [2,9], 5 [0,10] beats/ minute, respectively) and systolic blood pressure (10 [4,16], 11 [5,16], 7 [0,13] mmHg, respectively) after the T-tube trial. In conclusion, this research shows that old age and impaired respiratory mechanics contribute to different responses to spontaneous breathing trials with a T-tube and low-level pressure support. Further studies are needed to compare the effectiveness of the two SBT methods in predicting successful extubation in such patient groups. ? 2011 Anaesthesia and Intensive Care.
|ISSN:||0310-057X||DOI:||10.1177/0310057x1304100108||SDG/Keyword:||aged; article; artificial ventilation; breathing mechanics; chronic obstructive lung disease; comparative study; extubation; female; heart rate; human; lung compliance; lung resistance; major clinical study; male; medical history; observational study; pressure support ventilation; prospective study; respiratory function; respiratory tract parameters; senescence; spontaneous breathing trial; systolic blood pressure; age; artificial ventilation; blood pressure; breathing mechanics; chronic obstructive lung disease; metabolism; methodology; pathophysiology; physiology; risk factor; oxygen; Age Factors; Aged; Aged, 80 and over; Blood Pressure; Female; Heart Rate; Humans; Male; Oxygen; Prospective Studies; Pulmonary Disease, Chronic Obstructive; Respiration, Artificial; Respiratory Mechanics; Risk Factors; Ventilator Weaning
|Appears in Collections:||醫學系|
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