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maximal inspiratory pressure and extubation

https://read.qxmd.com/read/32282654/factors-associated-with-prolonged-mechanical-ventilation-and-reventilation-in-acute-cervical-spinal-cord-injury-patients
#1
Hung-Chen Wang, Kuan-Yi Chen, Yu-Tsai Lin, Wu-Fu Chen, Mei-Yun Liaw, Yu-Jun Lin, Fu-Yuan Shih, Shih-Yuan Hsu, Nai-Wen Tsai, Meng-Chih Lin, Cheng-Hsien Lu
MINI: In this study, respiratory function at the time of extubation can be useful optimal clinical guidelines for weaning and extubation attempts in patients with acute cervical spinal cord injury. Serum thiobarbituric acid-reactive substances level at admission can be a useful predictor for severity in acute cervical patients with spinal cord injury. STUDY DESIGN: Patients who had suffered from acute blunt cervical spinal cord injury (SCI) and admitted our hospital within 24 hours after injury were included in the study...
May 1, 2020: Spine
https://read.qxmd.com/read/31651674/factors-associated-with-prolonged-mechanical-ventilation-and-re-ventilation-in-acute-cervical-spinal-cord-injury-patients
#2
Hung-Chen Wang, Kuan-Yi Chen, Yu-Tsai Lin, Wu-Fu Chen, Mei-Yun Liaw, Yu-Jun Lin, Fu-Yuan Shih, Shih-Yuan Hsu, Nai-Wen Tsai, Meng-Chih Lin, Cheng-Hsien Lu
STUDY DESIGN: Patients who had suffered from acute blunt cervical spinal cord injury (SCI) and admitted our hospital within 24 hours after injury were included in the study. OBJECTIVE: We compared the respiratory function and serum reactive oxidative stress (ROS) after acute cervical SCI, and tried to find out the valuable predictors of weaning in acute cervical SCI patients. SUMMARY OF BACKGROUND DATA: Ventilation impairment is a major complication of acute cervical SCI...
October 22, 2019: Spine
https://read.qxmd.com/read/31315777/-research-advances-in-validity-of-predictors-for-extubation-outcome-in-children-receiving-invasive-mechanical-ventilation
#3
Zhen Zhang, Yang Xue, Hong-Hua Li, Yu-Mei Li
The development of invasive mechanical ventilation technology provides effective respiratory support for critically ill children. However, respiratory support is not the end of treatment as the ultimate goal is successful extubation in children. At present, some evaluation indicators before extubation including rapid shallow breathing index, maximal inspiratory pressure, and work of breathing are of high clinical value in predicting adult extubation outcome, but their evidence of evidence-based medicine is not sufficient in the field of pediatric intensive care...
July 2019: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://read.qxmd.com/read/31107378/relationship-between-diaphragmatic-electrical-activity-and-esophageal-pressure-monitoring-in-children
#4
Sandrine Essouri, Florent Baudin, Guillaume Mortamet, Jennifer Beck, Philippe Jouvet, Guillaume Emeriaud
OBJECTIVES: Mechanical ventilation is an essential life support technology, but it is associated with side effects in case of over or under-assistance. The monitoring of respiratory effort may facilitate titration of the support. The gold standard for respiratory effort measurement is based on esophageal pressure monitoring, a technology not commonly available at bedside. Diaphragmatic electrical activity can be routinely monitored in clinical practice and reflects the output of the respiratory centers...
July 2019: Pediatric Critical Care Medicine
https://read.qxmd.com/read/30654837/temporary-transvenous-diaphragm-pacing-vs-standard-of-care-for-weaning-from-mechanical-ventilation-study-protocol-for-a-randomized-trial
#5
Douglas Evans, Deborah Shure, Linda Clark, Gerard J Criner, Martin Dres, Marcelo Gama de Abreu, Franco Laghi, David McDonagh, Basil Petrof, Teresa Nelson, Thomas Similowski
BACKGROUND: Mechanical ventilation (MV) is a life-saving technology that restores or assists breathing. Like any treatment, MV has side effects. In some patients it can cause diaphragmatic atrophy, injury, and dysfunction (ventilator-induced diaphragmatic dysfunction, VIDD). Accumulating evidence suggests that VIDD makes weaning from MV difficult, which involves increased morbidity and mortality. METHODS AND ANALYSIS: This paper describes the protocol of a randomized, controlled, open-label, multicenter trial that is designed to investigate the safety and effectiveness of a novel therapy, temporary transvenous diaphragm pacing (TTVDP), to improve weaning from MV in up to 88 mechanically ventilated adult patients who have failed at least two spontaneous breathing trials over at least 7 days...
January 17, 2019: Trials
https://read.qxmd.com/read/29584447/inspiratory-muscle-rehabilitation-in-critically-ill-adults-a-systematic-review-and-meta-analysis
#6
Stefannie Vorona, Umberto Sabatini, Sulaiman Al-Maqbali, Michele Bertoni, Martin Dres, Bernie Bissett, Frank Van Haren, A Daniel Martin, Cristian Urrea, Debbie Brace, Matteo Parotto, Margaret S Herridge, Neill K J Adhikari, Eddy Fan, Luana T Melo, W Darlene Reid, Laurent J Brochard, Niall D Ferguson, Ewan C Goligher
RATIONALE: Respiratory muscle weakness is common in critically ill patients; the role of targeted inspiratory muscle training (IMT) in intensive care unit rehabilitation strategies remains poorly defined. OBJECTIVES: The primary objective of the present study was to describe the range and tolerability of published methods for IMT. The secondary objectives were to determine whether IMT improves respiratory muscle strength and clinical outcomes in critically ill patients...
June 2018: Annals of the American Thoracic Society
https://read.qxmd.com/read/29398169/efficacy-of-respiratory-muscle-training-in-weaning-of-mechanical-ventilation-in-patients-with-mechanical-ventilation-for-48hours-or-more-a-randomized-controlled-clinical-trial
#7
RANDOMIZED CONTROLLED TRIAL
L M Sandoval Moreno, I C Casas Quiroga, E C Wilches Luna, A F García
OBJECTIVE: To evaluate the efficacy of respiratory muscular training in the weaning of mechanical ventilation and respiratory muscle strength in patients on mechanical ventilation of 48hours or more. DESIGN: Randomized controlled trial of parallel groups, double-blind. Ambit: Intensive Care Unit of a IV level clinic in the city of Cali. PATIENTS: 126 patients in mechanical ventilation for 48hours or more. INTERVENTIONS: The experimental group received daily a respiratory muscle training program with treshold, adjusted to 50% of maximal inspiratory pressure, additional to standard care, conventional received standard care of respiratory physiotherapy...
March 2019: Medicina Intensiva
https://read.qxmd.com/read/29380080/reliability-of-respiratory-pressure-measurements-in-ventilated-and-non-ventilated-patients-in-icu-an-observational-study
#8
Clément Medrinal, Guillaume Prieur, Yann Combret, Aurora Robledo Quesada, Tristan Bonnevie, Francis Edouard Gravier, Eric Frenoy, Olivier Contal, Bouchra Lamia
BACKGROUND: Assessment of maximum respiratory pressures is a common practice in intensive care because it can predict the success of weaning from ventilation. However, the reliability of measurements through an intubation catheter has not been compared with standard measurements. The aim of this study was to compare maximum respiratory pressures measured through an intubation catheter with the same measurements using a standard mouthpiece in extubated patients. METHODS: A prospective observational study was carried out in adults who had been under ventilation for at least 24 h and for whom extubation was planned...
January 30, 2018: Annals of Intensive Care
https://read.qxmd.com/read/29209502/monitoring-diaphragm-function-in-a-patient-with-myasthenia-gravis-electrical-activity-of-the-diaphragm-vs-maximal-inspiratory-pressure
#9
Yukiko Koyama, Takeshi Yoshida, Akinori Uchiyama, Yuji Fujino
Background: Maximal inspiratory pressure (MIP) is used to assess respiratory muscle strength of patients with myasthenia gravis (MG) requiring ventilatory support. Electrical activity of the diaphragm (E-di) has been used to guide weaning. Case presentation: The MIP and tidal volume/ΔE-di (the patient-to-ventilator breath contribution) were monitored in a 12-year-old girl with MG requiring ventilator support. The same ventilatory settings were maintained until extubation...
2017: Journal of Intensive Care
https://read.qxmd.com/read/28813495/establishing-failure-predictors-for-the-planned-extubation-of-overweight-and-obese-patients
#10
Chien-Ming Chao, Chih-Cheng Lai, Ai-Chin Cheng, Shyh-Ren Chiang, Wei-Lun Liu, Chung-Han Ho, Shu-Chen Hsing, Chin-Ming Chen, Kuo-Chen Cheng
We investigated failure predictors for the planned extubation of overweight (body mass index [BMI] = 25.0-29.9) and obese (BMI ≥ 30) patients. All patients admitted to the adult intensive care unit (ICU) of a tertiary hospital in Taiwan were identified. They had all undergone endotracheal intubation for > 48 h and were candidates for extubation. During the study, 595 patients (overweight = 458 [77%]); obese = 137 [23%]) with planned extubation after weaning were included in the analysis; extubation failed in 34 patients (5...
2017: PloS One
https://read.qxmd.com/read/28693057/-the-value-of-the-excursion-of-diaphragm-tested-by-ultrosonography-to-predict-weaning-from-mechanical-ventilation-in-icu-patients
#11
L X Liu, D Su, Z J Hu
Objective: To evaluate the excursion of the diaphragm and analyze the value in predicting weaning from mechanical ventilation in intensive care unit patients. Methods: The patients with mechanical ventilation (>48 hours) in ICU at Hebei Forth Medical University Hospital from June 2014 to December were classified into a success group or a failure group according to the weaning outcome. T-piece spontaneous breathing (SBT), airway occlusion pressure at 0.1 sec (P(0.1)) and maximal inspiratory pressure (MIP), rapid shallow breathing index (RSBI) and P(0...
July 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://read.qxmd.com/read/27741103/establishing-predictors-for-successfully-planned-endotracheal-extubation
#12
Chih-Cheng Lai, Chin-Ming Chen, Shyh-Ren Chiang, Wei-Lun Liu, Shih-Feng Weng, Mei-I Sung, Shu-Chen Hsing, Kuo-Chen Cheng
The aim of this study was to establish predictors for successfully planned extubation, which can be followed by medical personnel. The patients who were admitted to the adult intensive care unit of a tertiary hospital and met the following criteria between January 2005 and December 2014 were collected retrospectively: intubation > 48 hours; and candidate for extubation. The patient characteristics, including disease severity, rapid shallow breath index (RSBI), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), cuff leak test (CLT) before extubation, and outcome, were recorded...
October 2016: Medicine (Baltimore)
https://read.qxmd.com/read/27706462/effectiveness-of-prophylactic-non-invasive-ventilation-on-respiratory-function-in-the-postoperative-phase-of-pediatric-cardiac-surgery-a-randomized-controlled-trial
#13
Camilla R S Silva, Lívia B Andrade, Danielle A S X Maux, Andreza L Bezerra, Maria C M B Duarte
Objective: To evaluate the effectiveness of prophylactic, non-invasive ventilation (NIV) on respiratory function in seven- to 16-year-old children in the post-operative phase of cardiac surgery. Method: A randomized, controlled trial with 50 children who had undergone cardiac surgery with median sternotomy. After extubation, patients were randomly assigned to one of two groups: control group (n=26), which received instructions regarding posture, early ambulation, and cough stimulation, and CPAP group (continuous positive airway pressure; n=24), which received the same instructions as the control group and CPAP=10 cmH20 twice daily for 30 minutes from the 1st to the 5th post-operative day (POD)...
November 2016: Brazilian Journal of Physical Therapy
https://read.qxmd.com/read/27475524/respiratory-weakness-after-mechanical-ventilation-is-associated-with-one-year-mortality-a-prospective-study
#14
Clément Medrinal, Guillaume Prieur, Éric Frenoy, Aurora Robledo Quesada, Antoine Poncet, Tristan Bonnevie, Francis-Edouard Gravier, Bouchra Lamia, Olivier Contal
BACKGROUND: Diaphragm dysfunction in mechanically ventilated patients is associated with poor outcome. Maximal inspiratory pressure (MIP) can be used to evaluate inspiratory muscle function. However, it is unclear whether respiratory weakness is independently associated with long-term mortality. The aim of this study was to determine if low MIP is independently associated with one-year mortality. METHODS: We conducted a prospective observational cohort study in an 18-bed ICU...
July 31, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/26167730/evolution-of-diaphragm-thickness-during-mechanical-ventilation-impact-of-inspiratory-effort
#15
Ewan C Goligher, Eddy Fan, Margaret S Herridge, Alistair Murray, Stefannie Vorona, Debbie Brace, Nuttapol Rittayamai, Ashley Lanys, George Tomlinson, Jeffrey M Singh, Steffen-Sebastian Bolz, Gordon D Rubenfeld, Brian P Kavanagh, Laurent J Brochard, Niall D Ferguson
RATIONALE: Diaphragm atrophy and dysfunction have been reported in humans during mechanical ventilation, but the prevalence, causes, and functional impact of changes in diaphragm thickness during routine mechanical ventilation for critically ill patients are unknown. OBJECTIVES: To describe the evolution of diaphragm thickness over time during mechanical ventilation, its impact on diaphragm function, and the influence of inspiratory effort on this phenomenon. METHODS: In three academic intensive care units, 107 patients were enrolled shortly after initiating ventilation along with 10 nonventilated intensive care unit patients (control subjects)...
November 1, 2015: American Journal of Respiratory and Critical Care Medicine
https://read.qxmd.com/read/26092389/inspiratory-muscle-training-facilitates-weaning-from-mechanical-ventilation-among-patients-in-the-intensive-care-unit-a-systematic-review
#16
REVIEW
Mark Elkins, Ruth Dentice
QUESTION: Does inspiratory muscle training improve inspiratory muscle strength in adults receiving mechanical ventilation? Does it improve the duration or success of weaning? Does it affect length of stay, reintubation, tracheostomy, survival, or the need for post-extubation non-invasive ventilation? Is it tolerable and does it cause adverse events? DESIGN: Systematic review of randomised trials. PARTICIPANTS: Adults receiving mechanical ventilation...
July 2015: Journal of Physiotherapy
https://read.qxmd.com/read/25299721/lack-of-accuracy-of-ventilatory-indexes-in-predicting-extubation-success-in-children-submitted-to-mechanical-ventilation
#17
Silvia Gatiboni, Jefferson Pedro Piva, Pedro Celiny Ramos Garcia, Cinthia Jonhston, Patrícia Hommerding, Flávia Franz, Lucien Gualdi
OBJECTIVES: Between 10% and 20% of children submitted to mechanical ventilation in the pediatric intensive care unit present extubation failure. Several ventilatory indexes have been proposed to predict extubation failure. The aim of this study was to analyze the accuracy of these indices in predicting successful extubation in children and to evaluate these variables according to the age of the patient and the specific disease. METHODS: A prospective observational study including all children submitted to mechanical ventilation in a Brazilian referral pediatric intensive care unit was conducted between August 2007 and August 2008...
June 2011: Revista Brasileira de Terapia Intensiva
https://read.qxmd.com/read/23739566/-a-multicenter-study-of-respiratory-multiple-index-in-predicting-weaning-from-mechanical-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#18
MULTICENTER STUDY
Zhi-bo Li, Xin-jing Gao, Dong-hao Wang, Bo Zhang, Zhen-ping Zhang, Zhong-min Hu, Lei Xu, Ying-zhi Qin
OBJECTIVE: To study the result of respiratory multiple index(compliance, respiratory rate, oxygenation, pressure, CROP) in predicting weaning from mechanical ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: A prospective study was conducted. Two hundred and fifteen patients weaning from mechanical ventilation with AECOPD in intensive care unit (ICU) of five tertiary hospitals from September 2010 to October 2012 were enrolled...
June 2013: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://read.qxmd.com/read/23663795/inspiratory-muscle-training-did-not-accelerate-weaning-from-mechanical-ventilation-but-did-improve-tidal-volume-and-maximal-respiratory-pressures-a-randomised-trial
#19
RANDOMIZED CONTROLLED TRIAL
Robledo L Condessa, Janete S Brauner, Andressa L Saul, Marcela Baptista, Ana C T Silva, Sílvia R R Vieira
QUESTION: Does inspiratory muscle training accelerate weaning from mechanical ventilation? Does it improve respiratory muscle strength, tidal volume, and the rapid shallow breathing index? DESIGN: Randomised trial with concealed allocation and intention-to-treat analysis. PARTICIPANTS: 92 patients receiving pressure support ventilation were included in the study and followed up until extubation, tracheostomy, or death. INTERVENTION: The experimental group received usual care and inspiratory muscle training using a threshold device, with a load of 40% of their maximal inspiratory pressure with a regimen of 5 sets of 10 breaths, twice a day, 7 days a week...
June 2013: Journal of Physiotherapy
https://read.qxmd.com/read/22607984/respiratory-muscle-assessment-in-predicting-extubation-outcome-in-patients-with-stroke
#20
Antonio A M Castro, Felipe Cortopassi, Russell Sabbag, Luis Torre-Bouscoulet, Claudia Kümpel, Elías Ferreira Porto
BACKGROUND: Patients with cerebral infarction often present impaired consciousness and unsatisfactory extubation. We aimed to assess the respiratory mechanics components that might be associated with the success of extubation in stroke patients. METHODS: Twenty consecutive patients with stroke who needed mechanical ventilation support were enrolled. The maximal inspiratory pressure, gastric and the esophageal pressure (Pdi/Pdimax), minute volume, respiratory rate, static compliance, airway resistance, rapid and superficial respiration index (RSRI), inspiratory time/total respiratory cycle (Ti/Ttot), and PaO(2)/FiO(2) were measured...
August 2012: Archivos de Bronconeumología
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