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The minute ventilation recovery time used as a predictor of weaning in patients with chronic obstructive pulmonary disease / 中华急诊医学杂志
Chinese Journal of Emergency Medicine ; (12): 89-92, 2014.
Article in Chinese | WPRIM | ID: wpr-443009
ABSTRACT
Objective To explore the value of minute ventilation recovery time (VERT) as a weaning predictor in mechanically ventilated patients with chronic obstructive pulmonary disease (COPD).Methods A prospective study was performed from March 2008 to July 2012.Fifty-two COPD patients under mechanical ventilation for more than 48 hours in our RICU tolerated a spontaneous breathing trial (SBT) and were ready for planned extubation.After SBT,these patients were placed back on their pre-SBT ventilator settings for up to 25 minutes,during which VERT was obtained.VERT was defined as the time for minute ventilation to return to baseline measured before SBT.Respiratory rate,tidal volume,minute ventilation and respiratory rate/tidal volume ratio were also obtained before SBT and just after SBT.Arterial blood gas data were measured and recorded before weaning.According to the weaning outcome,the patients were classified as successful group (40 cases) or failed group (12 cases).VERT and other quantitative variables were compared using t test.A multiple logistic regression was performed to explore possible factors associated with the weaning outcome.The sensitivity and specificity of VERT for predictive capacity in weaning were assessed using ROC cure.Results VERT and respiratory rate after SBT were significantly different between two groups.Multiple logistic regression revealed that VERT was the only predictor associated with weaning outcome (b =0.282,P <0.001).The area under ROC curve for VERT was 0.957 (95% CIO.907-1.008).With a cut-off value of 10.5 minutes,the sensitivity and specificity of VERT for predicting weaning failure were 1.0 and 0.85,respectively.Conclusions VERT may be a new predictor for extubation and determination of mechanical ventilation weaning in patients with COPD.VERT is a variable to be easily measured thereby being conveniently used in clinical practice.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Observational study / Prognostic study Language: Chinese Journal: Chinese Journal of Emergency Medicine Year: 2014 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Observational study / Prognostic study Language: Chinese Journal: Chinese Journal of Emergency Medicine Year: 2014 Type: Article