ELEVATED STATIC COMPLIANCE OF THE TOTAL RESPIRATORY SYSTEM - EARLY PREDICTOR OF WEANING UNSUCCESS IN SEVERE COPD PATIENTS MECHANICALLY VENTILATED

被引：16

作者：

ZANOTTI, E

RUBINI, F

IOTTI, G

BRASCHI, A

PALO, A

BRUSCHI, C

FRACCHIA, C

NAVA, S

机构：

[1] FDN CLIN LAVORO,IRCCS,CTR MED RIABILITAZ MONTESCANO,DIV PNEUMOL,I-27040 MONTESCANO,ITALY

[2] OSPED POLICLIN S MATTEO,IRCCS,SERV RIANIMAZ 1,PAVIA,ITALY

来源：

INTENSIVE CARE MEDICINE | 1995年 / 21卷 / 05期

关键词：

RESPIRATORY MECHANICS; WEANING PREDICTION; COPD;

D O I：

10.1007/BF01707408

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objective: To assess in a group of COPD patients mechanically ventilated for an episode of acute respiratory failure the respiratory mechanics with a simple and non invasive method at the bedside in order to evaluate if these parameters may be predictive of weaning failure or success. Design: A prospective study. Setting: Intensive care and intermediate intensive care units. Patients: 23 COPD patients ventilated for acute respiratory failure and studied within 24 hours from intubation. Methods: Using end-expiratory and end-inspiratory airway occlusion technique, we measured PEEPi, static compliance of the respiratory system (Crs, st) maximum respiratory resistance (Rrsmax) and minimum respiratory resistance (Rrsmin). Measurements and results: The weaned group (A) and the not weaned group (B) were not different regarding to static PEEPi (group A 8.5 +/- 4.0 vs group B 8.9 +/- 2.6 cmH(2)O), to Rrsmax (22.4 +/- 5.3 versus 22.2 +/- 9.0 cmH(2)O/I/s) and to Rrsmin (17.6 +/- 5.5 versus 17.9 +/- 8.0 cmH(2)O/l/s), while a significant difference (p<0.001) has been found in Cst, rs (62.7 +/- 17.5 versus 111.6 +/- 18.0 ml/cm H2O). The threshold value of 88.5 ml/cmH(2)O was identified by discriminant analysis and provided the best separation between the two groups, with a sensitivity of 0.85 and a specificity of 0.87. Conclusion: Cst, rs measured non invasively in the first 24 h from intubation, provided a good separation between the patients who were successfully weaned and those who failed.

引用

页码：399 / 405

页数：7

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