Extubation Readiness and Neuroventilatory Efficiency After Acute Respiratory Failure
The aim of this study was to compare the indices of rapid shallow breathing, neuromechanical efficiency (NME), and neuroventilatory efficiency (NVE) between patients being successfully extubated and those who failed weaning.
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Department of Critical Care Medicine, Nanjing Zhong-Da Hospital, Southeast University School of Medicine, China; Department of Critical Care Medicine St. Michaels's Hospital, University of Toronto, Canada|
- Neuroventilatory Efficiency (NVE) [ Time Frame: at 30 minutes of the spontaneous breathing trials (SBT) ] [ Designated as safety issue: No ]NVE is the ratio of tidal volume and diaphragm electrical activity (Vt/EAdi).It is a value describing how effective a patient's breathing is.
- Neuromechanical Efficiency (NME) [ Time Frame: at 30 minutes of the spontaneous breathing trials (SBT) ] [ Designated as safety issue: No ]NME is the ratio between inspiratory pressure generation and EAdi (Paw/EAdi).
Biospecimen Retention: Samples Without DNA
Parameters of arterial blood gases, haemodynamic and mechanics of breathing
|Study Start Date:||December 2008|
|Study Completion Date:||July 2010|
|Primary Completion Date:||July 2010 (Final data collection date for primary outcome measure)|
Weaning failure:(1) failed SBT; (2) reintubation and /or resumption of support following successful extubation; or (3) die 48h following extubation.
Weaning successful:extubation and the absence of ventilatory support 48 h following the extubation
Patients, mechanically ventilated for > 24 h, were included when they met criteria for their first spontaneous breathing trial (SBT) on continuous positive airway pressure (CPAP) (5-6 cmH2O) for 30 minutes. Patients who did not fulfill the criteria for successful SBT, or required assist, or deceased within 48h post-extubation were considered extubation failure (F). Patients who completed the SBT and remained extubated > 48 h were considered successfully extubated (S). Before and during the SBT, arterial blood gases, heart, rate, blood pressure, and EAdi, flow, Vt, f, and, airway pressure (Paw) were measured. At 0, 5, 10, 15 and 30 minutes of the SBT, f/Vt, diaphragm electrical activity (EAdi), NME, and NVE were calculated. NME was calculated as Paw/EAdi during inspiratory occlusion. NVE was calculated as Vt/EAdi during unassisted inspirations.Arterial blood gases, heart rate, and blood pressure were measured. The receiver operating characteristic (ROC) curve was calculated to evaluate the predictive performance of each index.
|Nanjing Zhong-Da Hospital|
|Nanjing, Jiangsu, China, 21009|
|Study Director:||Haibo Qiu, MD, Phd||Southeast University|