期刊
BRITISH JOURNAL OF ANAESTHESIA
卷 111, 期 6, 页码 955-960出版社
OXFORD UNIV PRESS
DOI: 10.1093/bja/aet258
关键词
mechanical ventilator weaning; neurally adjusted ventilatory assist
Neuro-ventilatory efficiency (NVE), defined as the tidal volume to electrical diaphragm-activity ratio (V-T/EAdi) at the beginning and end of the weaning process after acute hypoxaemic respiratory failure, may provide valuable information about patient recovery. This observational study included 12 patients breathing with neurally adjusted ventilatory assist (NAVA). When a spontaneous breathing trial (SBT) with pressure support of 7 cm H2O and PEEP was unsuccessful, NAVA was used and the level was adjusted to obtain an EAdi of 60 of maximal EAdi during SBT. V-T and EAdi were recorded continuously. We compared changes in NVE between NAVA and SBT at the first failed and first successful SBT. When patients were switched from NAVA to SBT, NVE was significantly reduced during both unsuccessful and successful SBT (56 and 38, respectively); however, this reduction was significantly lower when SBT was successful (P0.01). Between the first and last day of weaning, we observed that NVE decreased with NAVA [40.6 (27.789.5) vs 28.8 (18.646.7); P0.002] with a significant decrease in NAVA level, whereas it remained unchanged during SBT [15.4 (10.739.1) vs 19.5 (11.629.6); P0.50] with significant increases in both EAdi and V-T and no difference in respiratory rhythm. These results suggest that in patients after respiratory failure and prolonged mechanical ventilation, changes in V-T and NVE, between SBTs are indicative of patient recovery. Larger clinical trials are needed to clarify whether changes in NVE reliably predict weaning in patients ventilated with NAVA.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据