Respiratory Muscle Effort during Expiration in Successful and Failed Weaning from Mechanical Ventilation

Anesthesiology
Jonne DoorduinLeo M A Heunks

Abstract

WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Respiratory muscle weakness in critically ill patients is associated with difficulty in weaning from mechanical ventilation. Previous studies have mainly focused on inspiratory muscle activity during weaning; expiratory muscle activity is less well understood. The current study describes expiratory muscle activity during weaning, including tonic diaphragm activity. The authors hypothesized that expiratory muscle effort is greater in patients who fail to wean compared to those who wean successfully. Twenty adult patients receiving mechanical ventilation (more than 72 h) performed a spontaneous breathing trial. Tidal volume, transdiaphragmatic pressure, diaphragm electrical activity, and diaphragm neuromechanical efficiency were calculated on a breath-by-breath basis. Inspiratory (and expiratory) muscle efforts were calculated as the inspiratory esophageal (and expiratory gastric) pressure-time products, respectively. Nine patients failed weaning. The contribution of the expiratory muscles to total respiratory muscle effort increased in the "failure" group from 13 ± 9% at onset to 24 ± 10% at the end of the breathing trial (P = 0.047); there was no increase in the "success" gro...Continue Reading

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Citations

Jul 6, 2018·Anesthesiology·Giacomo Grasselli, Giacomo Bellani
Apr 18, 2019·Anesthesiology·Uğur ÖzdemirAntonio M Esquinas
Apr 18, 2019·Anesthesiology·Jonne Doorduin, Leo Heunks
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Nov 26, 2019·Current Opinion in Critical Care·Irene Telias, Savino Spadaro
Jan 18, 2020·American Journal of Respiratory and Critical Care Medicine·Franco Laghi, Hameeda Shaikh
Jan 11, 2020·Journal of Clinical Monitoring and Computing·Andrea CoppadoroGiuseppe Foti
Mar 25, 2020·Critical Care : the Official Journal of the Critical Care Forum·Annemijn H JonkmanLeo M A Heunks
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Jun 27, 2019·Intensive Care Medicine·Zhong-Hua ShiLeo Heunks
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Dec 19, 2020·Current Opinion in Critical Care·Mark E HaaksmaLeo Heunks
Sep 3, 2021·Journal of Applied Physiology·Diana JansenLeo Heunks

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