Transitional Percentage of Minute Volume as a Novel Predictor of Weaning from Mechanical Ventilation in Patients with Chronic Respiratory Failure
| Autor: | Chin-Pyng Wu, Chou-Chin Lan, Yao-Kuang Wu, Mei-Chen Yang, Ya-Ru Liang, Shiang-Yu Huang, Pei-Yi Wu, I-Shiang Tzeng |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_treatment Vital Capacity 03 medical and health sciences Work of breathing 0302 clinical medicine medicine Humans Weaning Prospective Studies 030212 general & internal medicine General Nursing Tidal volume Aged Aged 80 and over lcsh:RT1-120 Mechanical ventilation lcsh:Nursing 030504 nursing business.industry Area under the curve General Medicine Middle Aged Respiration Artificial Respiratory failure Anesthesia Rapid shallow breathing index Female Respiratory Insufficiency 0305 other medical science business Ventilator Weaning Respiratory minute volume |
| Zdroj: | Asian Nursing Research, Vol 14, Iss 1, Pp 30-35 (2020) |
| ISSN: | 1976-1317 |
| DOI: | 10.1016/j.anr.2020.01.002 |
| Popis: | Purpose: Some patients with respiratory failure fail initial weaning attempts and need prolonged mechanical ventilation (MV). Prolonged MV is associated with many complications and consumption of heathcare resources. Objective weaning indices help staffs to identify high-potential patients for weaning from the MV. Traditional weaning indices are not reliable in clinical practice. Transitional percentage of minute volume (TMV%) is a new index of the work of breathing. This study aimed to investigate the utility of TMV% in the prediction of weaning potential. Methods: This study was prospectively performed including all patients with prolonged MV. Researchers recorded their demographics, TMV%, respiratory parameters, Acute Physiology and Chronic Health Evaluation II score, and laboratory data upon arrival at the respiratory care center. The factors associated with successful weaning were analyzed. Results: Out of the 120 patients included, 84 (70.0%) were successfully weaned from MV. Traditional weaning indices such as rapid shallow breathing index could not predict the weaning outcome. TMV% was a valuable parameter as patients with a lower TMV%, higher tidal volume, higher hemoglobin, lower blood urea nitrogen, and lower Acute Physiology and Chronic Health Evaluation II scores had a higher rate of successful weaning. TMV%, tidal volume, and HCO3- levels were independent predictors of successful weaning, and the area under the curve was .79 in the logistic regression model. Conclusion: TMV% is a novel and effective predictor of successful weaning. Patients with lower TMV% had a higher MV weaning outcome. Once patients with a high potential for successful weaning are identified, they should be aggressively weaned from MV as soon as possible. Clinical Trials Government Identifier: NCT033480. Keywords: respiratory insufficiency, ventilators, mechanical, work of breathing |
| Databáze: | OpenAIRE |
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