End-expiratory lung volumes during spontaneous breathing trials in tracheostomized subjects on prolonged mechanical ventilation

0Citations
Citations of this article
19Readers
Mendeley users who have this article in their library.

Abstract

BACKGROUND: The role of end-expiratory lung volume (EELV) during a spontaneous breathing trial (SBT) in patients who were tracheostomized and on prolonged mechanical ventilation is unclear. This study aimed to assess EELV during a 60-min SBT and its correlation with weaning success. METHODS: Enrolled subjects admitted to a weaning unit were measured for EELV and relevant parameters before and after the SBT. RESULTS: Of the 44 enrolled subjects, 29 (66%) were successfully liberated, defined as not needing mechanical ventilation for 5 d. The success group had fewer subjects with chronic kidney disease (41% vs 73%, P = .044), stronger mean ± SD maximum inspiratory pressure (41.6 ± 10.4 vs 34.1 ± 7.1 cm H2O;P= .02) and mean ± SD maximum expiratory pressure (46.9 ± 11.7 vs 35.3 ± 16.9 cm H2O;P= .01) versus the failure group. Toward the end of the SBT, the success group had a significant increase in the mean ± SD EELV (before vs after: 1,278 ± 744 vs 1,493 ± 867 mL; P = .040) and a decrease in the mean ± SD rapid shallow breathing index (83.8 ± 39.4 vs 66.3 ± 29.4; P = .02), whereas there were no significant changes in these 2 parameters in the failure group. The Cox regression analysis showed that, at the beginning of SBT, a greater difference between EELV with a PEEP of 0 cm H2O and with a PEEP of 5 cm H2O was significantly correlated to a higher likelihood of weaning success. Toward the end of the SBT, a greater EELV level at a PEEP of 0 cm H2O was also correlated with weaning success. Also, the greater difference of EELV at a PEEP of 0 cm H2O between the beginning and the end of the SBT was also correlated with a shorter duration to weaning success. CONCLUSIONS: The change in EELV during a 60-min SBT may be of prognostic value for liberation from prolonged mechanical ventilation in patients who had a tracheostomy. Our findings suggest a model to understand the underlying mechanism of failure of liberation from mechanical ventilation in these patients.

References Powered by Scopus

Weaning from mechanical ventilation

1452Citations
N/AReaders
Get full text

Chronic critical illness

485Citations
N/AReaders
Get full text

Management of patients requiring prolonged mechanical ventilation: Report of a NAMDRC Consensus Conference

471Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Cheng, J. C., Chen, H. C., Jerng, J. S., Kuo, P. H., & Wu, H. D. (2021). End-expiratory lung volumes during spontaneous breathing trials in tracheostomized subjects on prolonged mechanical ventilation. Respiratory Care, 66(11), 1704–1712. https://doi.org/10.4187/respcare.08957

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 5

83%

Researcher 1

17%

Readers' Discipline

Tooltip

Medicine and Dentistry 4

50%

Nursing and Health Professions 4

50%

Article Metrics

Tooltip
Social Media
Shares, Likes & Comments: 9

Save time finding and organizing research with Mendeley

Sign up for free