دورية أكاديمية
أعرض في EDS

Occurrence of pendelluft under pressure support ventilation in patients who failed a spontaneous breathing trial: an observational study.

التفاصيل البيبلوغرافية
العنوان: Occurrence of pendelluft under pressure support ventilation in patients who failed a spontaneous breathing trial: an observational study.
المؤلفون: Coppadoro A; Department of Anesthesia and Intensive Care, San Gerardo Hospital, Monza, Italy., Grassi A; School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy., Giovannoni C; School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy., Rabboni F; School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy., Eronia N; Department of Anesthesia and Intensive Care, San Gerardo Hospital, Monza, Italy., Bronco A; Department of Anesthesia and Intensive Care, San Gerardo Hospital, Monza, Italy., Foti G; Department of Anesthesia and Intensive Care, San Gerardo Hospital, Monza, Italy.; School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy., Fumagalli R; School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy., Bellani G; Department of Anesthesia and Intensive Care, San Gerardo Hospital, Monza, Italy. giacomo.bellani1@unimib.it.; School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy. giacomo.bellani1@unimib.it.
المصدر: Annals of intensive care [Ann Intensive Care] 2020 Apr 07; Vol. 10 (1), pp. 39. Date of Electronic Publication: 2020 Apr 07.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 101562873 Publication Model: Electronic Cited Medium: Print ISSN: 2110-5820 (Print) Linking ISSN: 21105820 NLM ISO Abbreviation: Ann Intensive Care Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Heidelberg : Springer-Verlag, 2011-
مستخلص: Background: Pendelluft, the movement of gas within different lung regions, is present in animal models of assisted mechanical ventilation and associated with lung overstretching. Due to rebreathing of CO 2 as compared to fresh gas, pendelluft might reduce ventilatory efficiency possibly exacerbating patient's respiratory workload during weaning. Our aim was to measure pendelluft by electrical impedance tomography (EIT) in patients who failed a spontaneous breathing trial (SBT).
Methods: This is an observational study conducted in a general intensive care unit of a tertiary-level teaching hospital. EIT signal was recorded in 20 patients while pressure support (PS) ventilation was progressively reduced from clinical level (baseline) to 2 cmH 2 O, as in an SBT; four ventral-to-dorsal lung regions of interest were identified for pendelluft measurement. A regional gas movement (> 6 mL) occurring in a direction opposite to the global EIT signal was considered diagnostic for high pendelluft.
Results: Eight patients out of 20 (40%) were classified as high-pendelluft; baseline clinical characteristics did not differ between high- and low-pendelluft patients. At PS reduction, pendelluft and EtCO 2 increased more in the high-pendelluft group (p < .001 and .011, respectively). The volume of gas subject to pendelluft moved almost completely from the ventral towards the dorsal lung regions, while the opposite movement was minimal (16.3 [10:32.8] vs. 0 [0:1.8] mL, p = .001). In a subgroup of patients, increased pendelluft volumes positively correlated with markers of respiratory distress such as increased respiratory rate, p0.1, and EtCO 2 .
Conclusions: Occult pendelluft can be measured by EIT, and is frequently present in patients failing an SBT. When present, pendelluft increases with the reduction of ventilator support and is associated with increased EtCO 2 , suggesting a reduction of the ability to eliminate CO 2 .
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فهرسة مساهمة: Keywords: Assisted mechanical ventilation; Difficult ventilator weaning; Electrical impedance tomography; Pendelluft; Spontaneous assisted breathing; Spontaneous breathing trial
تواريخ الأحداث: Date Created: 20200409 Latest Revision: 20200928
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC7138895
DOI: 10.1186/s13613-020-00654-y
PMID: 32266600
قاعدة البيانات: MEDLINE
الوصف
تدمد:2110-5820
DOI:10.1186/s13613-020-00654-y