Changes in breathing pattern and respiratory muscle performance parameters during difficult weaning

Critical Care Medicine
X J CapdevilaC Prefaut

Abstract

This study examined, using noninvasive means, the changes in breathing pattern and inspiratory muscle pressure-time indices during difficult progressive withdrawal of pressure-support ventilation. A prospective analysis of the temporal evolution of several respiratory variables in difficult-to-wean patients. A university hospital intensive care unit. A heterogeneous group of 17 patients receiving prolonged mechanical ventilation. Daily measurements of breathing pattern and respiratory muscle performance parameters in difficult-to-wean patients. We examined breathing pattern variables, rapid shallow breathing (respiratory rate/tidal volume), tracheal occlusion pressure, maximal inspiratory pressure (P(I)max), and the tension-time index of the inspiratory muscles (TTmus = P(I)/P(I)max x Ti/Ttot) (where Ti/Ttot is inspiratory fraction of the cycle). All measurements were repeated at 24-hr intervals throughout the difficult weaning period. The patients were extubated on satisfying ten of 12 classical weaning criteria. Eleven patients were successfully weaned from mechanical ventilation while six patients were not. Weaning failure was associated with the following: a) longer periods of mechanical ventilation before weaning; b) high ...Continue Reading

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