Cardiothoracic & vascular anesthesia
Effects of two ventilator-weaning methods on lung volume and ventilation distribution by electrical impedance tomography in post-cardiac surgery patients: a prospective cohort study
Authors' conclusion
The successful weaning patients had a higher reduction of EELVloss PSV and a lower reduction of EELVloss T-piece. In the weaning failure patients, the paradox of lower EELVloss PSV that was accompanied by a high RR and low VT might be associated with air trapping.
Study context
- Population
- Post-cardiac surgery patients undergoing 30-min PSV-SBT (PS 8 cmH2O, ZEEP) followed by 30-min T-piece trialcomplied with both spontaneous breathing trial (SBT) steps
- Participants
- 60 patients
- Exposure
- Success vs Failure
- Successn = 43reference
- Failuren = 17
- Outcome
- EELVloss and pendelluft by weaning outcome
Methodological detailsprospective observational
- Prospective observational
Main finding
As reported in the abstract
Pendelluft incidence
52.9% vs. 23.3%
P = 0.045
Failure vs Success
EELVloss at T-piece SBT 30 min, median [IQR]
623[459,746] vs. 511[376,702] ml
P = 0.003
Failure vs Success
EELVloss pressure-support ventilation (PSV), median [IQR]
322[247,459] vs. 199[166, 269] ml
P < 0.001
Success vs Failure · abnormal pattern
Observational data: associations, not effects.
Further findings
Pendelluft incidence
P = 0.045
EELVloss · T-piece SBT 30 min
P = 0.003
EELVloss PSV · PSV-SBT 30 min · abnormal pattern
P < 0.001
| Outcome | P value |
|---|---|
| TIV · PSV-SBT 30 min | P = 0.005 |
| Weaning failure rate by volume-loss patternT-volume loss vs P-volume loss | P < 0.001 |
| Baseline dorsal ventilation by volume-loss patternT-volume loss vs P-volume loss | P = 0.023 |
- Baseline dorsal ventilation by volume-loss pattern — ROC: dorsal ventilation threshold associated with T-volume loss
- 40.5%
- Weaning failure rate by volume-loss pattern: T-volume loss 52.2%
- Weaning failure rate by volume-loss pattern: P-volume loss 13.5%
- Baseline dorsal ventilation by volume-loss pattern: T-volume loss 39% (IQR 37%,43%)
- Baseline dorsal ventilation by volume-loss pattern: P-volume loss 44% (IQR 41%,50%)
Respiratory rate, failure group vs baseline · PSV-SBT 30 min
- Higher RR at PSV-SBT 30 min than baseline in failure group
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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