Response to hypercapnic challenge is associated with successful weaning from prolonged mechanical ventilation due to brain stem lesions

Yao Kuang Wu, Chih Hsin Lee, Ben Chang Shia, Ying Huang Tsai, T. C Y Tsao

研究成果: 雜誌貢獻文章同行評審

6 引文 斯高帕斯(Scopus)

摘要

We propose that higher airway occlusion pressure (P0.1) responses to hypercapnic challenge (HC) indicate less severe injury. The study aim was to determine whether P0.1 responses to HC were associated with successful weaning after prolonged mechanical ventilation (PMV) in patients with brainstem lesions and to determine a reference value for clinical use. Forty-two patients with brainstem lesions on PMV were recruited. Breathing parameters and P0.1 were measured before HC. Three-minute HC challenges with increasing CO2 concentrations were initiated and P0.1, respiratory rate, minute ventilation (V e), tidal volume (V t) and end tidal CO2 were measured. Patients were classified into high (group I) and low (group II) response groups on the basis of P0.1 responses to HC. Increases in V e and V t after HC were significantly greater in group I patients (12.22 ± 8.22 vs. 3.08 ± 4.84 L/min, P <0.001 and 399.11 ± 278.18 vs. 110.54 ± 18.275 ml, P <0.001). P0.1 levels were significantly higher in group I compared to group II before HC (2.69 ± 1.81 vs. 1.28 ± 1.04 cmH2O, P = 0.003). The increase in P0.1 following HC was significantly greater in group I compared to group II patients (11.05 ± 4.06 vs. 2.90 ± 2.53 cmH2O, P <0.001). Weaning success was significantly higher in group I compared to group II patients (72.2% vs. 33.3%, P = 0.02). A P0.1 increase of >6 cmH2O following HC was significantly associated with successful weaning. Assessing the P.01 response to serial increases in the level of HC may be a safe means to ascertain whether patients with brainstem lesions are ready for ventilator weaning.

原文英語
頁(從 - 到)108-114
頁數7
期刊Intensive Care Medicine
35
發行號1
DOIs
出版狀態已發佈 - 1月 2009
對外發佈

ASJC Scopus subject areas

  • 重症監護和重症監護醫學

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