Diaphragm electromyographic activity as a predictor of weaning failure
Purpose To compare breathing pattern descriptors and diaphragm electromyographic activity (EAdi)-derived indices obtained from a neurally adjusted ventilatory assist catheter during a spontaneous breathing trial (SBT) in patients successfully and unsuccessfully separated from the ventilator and to a...
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Veröffentlicht in: | Intensive care medicine 2012-12, Vol.38 (12), p.2017-2025 |
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Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
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Zusammenfassung: | Purpose
To compare breathing pattern descriptors and diaphragm electromyographic activity (EAdi)-derived indices obtained from a neurally adjusted ventilatory assist catheter during a spontaneous breathing trial (SBT) in patients successfully and unsuccessfully separated from the ventilator and to assess their performance as a potential marker to discriminate these two categories of patients.
Methods
Fifty-seven ready-to-wean patients were included in a prospective observational study. During a 30-min SBT (pressure support 7 cmH
2
O, zero end expiratory pressure), tidal volume (
V
T
) and respiratory rate (RR) were obtained from the flow signal at baseline and at 3, 10, 20 and 30 min during the SBT. EAdi-derived indices were simultaneously computed: maximum of the EAdi (EAdi
max
), area under the inspiratory curve of EAdi (EAdi
AUC
), the difference between EAdi
max
and EAdi
min
(∆EAdi), EAdi
max
/
V
T
, EAdi
AUC
/
V
T
and ∆EAdi/
V
T
. Patients, successfully (success group;
n
= 35) and unsuccessfully (failure group;
n
= 22) separated from the ventilator were compared.
Results
At baseline, the breathing pattern was similar in the two groups, whereas EAdi
max
and EAdi
AUC
were significantly lower in the success group (
p
|
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ISSN: | 0342-4642 1432-1238 |
DOI: | 10.1007/s00134-012-2700-3 |