期刊
ACTA ANAESTHESIOLOGICA SCANDINAVICA
卷 61, 期 9, 页码 1166-1175出版社
WILEY
DOI: 10.1111/aas.12959
关键词
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资金
- Far Eastern Memorial Hospital [FEMH-2015-C-069]
- German Federal Ministry of Education and Research [03FH038I3 MOSES]
BackgroundThe study objective was to examine the correlation between regional ventilation distribution measured with electrical impedance tomography (EIT) and weaning outcomes during spontaneous breathing trial (SBT). MethodsFifteen patients received 100% automatic tube compensation (ATC) during the first and 70% during the second hour. Another 15 patients received external continuous positive airway pressure (CPAP) of 5 and 7.5 cmH(2)O during the first and second hours, respectively. Regional ventilation distributions were monitored with EIT. ResultsTidal volume and tidal variation of impedance correlated significantly during assist-control ventilation and ATC in all patients (r(2) = 0.80 0.18, P < 0.001). Higher support levels resulted in similar ventilation distribution and tidal volume, but higher end-expiratory lung impedance (EELI) (P < 0.05). Analysis of regional intratidal gas distribution revealed a redistribution of ventilation towards dorsal regions with lower support level in 13 of 30 patients. These patients had a higher weaning success rate (only 1 of 13 patients failed). Eight of 17 other patient failed (P < 0.05). The number of SBT days needed for weaning was significantly lower in the former group of 13 patients (13.1 +/- 4.0 vs. 20.9 +/- 11.2 days, P < 0.05). ConclusionsRegional ventilation distribution patterns during inspiration were associated with weaning outcomes, and they may be used to predict the success of extubation.
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