Skip to main content
 

Main menu

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Archives
    • Most-Read Papers of 2022
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Reviewer Guidelines: Original Research
    • Reviewer Guidelines: Reviews
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • 2023 Open Forum
    • 2023 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Videos
    • Video Abstracts
    • Author Interviews
    • The Journal

User menu

  • Subscribe
  • My alerts
  • Log in

Search

  • Advanced search
American Association for Respiratory Care
  • Subscribe
  • My alerts
  • Log in
American Association for Respiratory Care

Advanced Search

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Archives
    • Most-Read Papers of 2022
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Reviewer Guidelines: Original Research
    • Reviewer Guidelines: Reviews
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • 2023 Open Forum
    • 2023 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Videos
    • Video Abstracts
    • Author Interviews
    • The Journal
  • Twitter
  • Facebook
  • YouTube
Research ArticleOriginal Contributions

Hypercapnia Test As a Predictor of Success in Spontaneous Breathing Trials and Extubation

Joan M Raurich, Gemma Rialp, Jordi Ibáñez, Carlos Campillo, Ignacio Ayestarán and Carmen Blanco
Respiratory Care August 2008, 53 (8) 1012-1018;
Joan M Raurich
Intensive Care Unit, Hospital Universitario Son Dureta, Palma de Mallorca, Spain.
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: [email protected]
Gemma Rialp
Intensive Care Unit, Son Llàtzer Hospital, Palma de Mallorca, Spain.
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jordi Ibáñez
Intensive Care Unit, Hospital Universitario Son Dureta, Palma de Mallorca, Spain.
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Carlos Campillo
Intensive Care Unit, Hospital Universitario Son Dureta, Palma de Mallorca, Spain.
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ignacio Ayestarán
Intensive Care Unit, Hospital Universitario Son Dureta, Palma de Mallorca, Spain.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Carmen Blanco
Intensive Care Unit, Hospital Universitario Son Dureta, Palma de Mallorca, Spain.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • References
  • PDF
Loading

Abstract

BACKGROUND: The ventilatory capacity of the respiratory neuromuscular system can be studied with the hypercapnia test.

OBJECTIVE: To determine whether decreased response to the hypercapnia test is associated with failure to pass a spontaneous breathing trial (SBT) or extubation failure.

METHODS: We studied 103 intubated patients ready for SBT. We used a hypercapnia test in which we approximately doubled the dead space and thus caused re-inhalation of expired air. We calculated 3 ratios: the ratio of P0.1 (airway occlusion pressure 0.1 s after the onset of inspiratory effort) during hypercapnia test to baseline P0.1; the ratio of the change in minute volume [ΔVE] to the change in PaCO2 (we call this ratio the hypercapnic ventilatory response); and the ratio of the change in P0.1 [ΔP0.1] to the change PaCO2 (we call this ratio the hypercapnic-respiratory-drive response).

RESULTS: Thirty-six patients failed the SBT, and 11 patients failed extubation. The mean values for the SBT/extubation-success group, the extubation-failure group, and the SBT-failure group, respectively, were: ratio of hypercapnia-test P0.1 to baseline P0.1: 4.3 ± 2.7, 3.7 ± 1.3, and 3.0 ± 1.8 (P = .03); hypercapnic ventilatory response: 0.60 ± 0.35 L/min/mm Hg, 0.50 ± 0.26 L/min/mm Hg, and 0.31 ± 0.21 L/min/mm Hg (P < .001); hypercapnic respiratory-drive response: 0.48 ± 0.24 cm H2O/mm Hg, 0.42 ± 0.19 cm H2O/mm Hg, and 0.27 ± 0.15 cm H2O/mm Hg (P < .001). For predicting SBT/extubation success, the sensitivities and specificities, respectively, were: ratio of hypercapnia-test P0.1 to baseline P0.1 0.80 and 0.47; hypercapnic ventilatory response 0.86 and 0.53; hypercapnic respiratorydrive response 0.82 and 0.55.

CONCLUSIONS: The SBT/extubation-failure patients had less response to the hypercapnia test than did the SBT/extubation-success patients, and the hypercapnia test was not useful in predicting SBT or extubation success.

  • mechanical ventilation
  • intensive care
  • ventilator weaning
  • hypercapnia
  • spontaneous breathing trial
  • respiratory function tests
  • respiratory center

Footnotes

  • Correspondence: Joan M Raurich PhD, Intensive Care Unit, Hospital Universitario Son Dureta, C/ Andrea Doria 55, 07014 Palma de Mallorca, Spain. E-mail: jmraurich{at}hsd.es.
  • This research was supported by the Red de Investigación en Insuficiencia Respiratoria Aguda (Acute Respiratory Failure Research Network [Red GIRA]) of the Instituto de Salud Carlos III, Spain.

  • Copyright © 2008 by Daedalus Enterprises Inc.
PreviousNext
Back to top

In this issue

Respiratory Care: 53 (8)
Respiratory Care
Vol. 53, Issue 8
1 Aug 2008
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author

 

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Association for Respiratory Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Hypercapnia Test As a Predictor of Success in Spontaneous Breathing Trials and Extubation
(Your Name) has sent you a message from American Association for Respiratory Care
(Your Name) thought you would like to see the American Association for Respiratory Care web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Hypercapnia Test As a Predictor of Success in Spontaneous Breathing Trials and Extubation
Joan M Raurich, Gemma Rialp, Jordi Ibáñez, Carlos Campillo, Ignacio Ayestarán, Carmen Blanco
Respiratory Care Aug 2008, 53 (8) 1012-1018;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Hypercapnia Test As a Predictor of Success in Spontaneous Breathing Trials and Extubation
Joan M Raurich, Gemma Rialp, Jordi Ibáñez, Carlos Campillo, Ignacio Ayestarán, Carmen Blanco
Respiratory Care Aug 2008, 53 (8) 1012-1018;
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
  • Info & Metrics
  • References
  • PDF

Related Articles

Cited By...

Keywords

  • mechanical ventilation
  • intensive care
  • ventilator weaning
  • hypercapnia
  • spontaneous breathing trial
  • respiratory function tests
  • respiratory center

Info For

  • Subscribers
  • Institutions
  • Advertisers

About Us

  • About the Journal
  • Editorial Board

AARC

  • Membership
  • Meetings
  • Clinical Practice Guidelines

More

  • Contact Us
  • RSS
American Association for Respiratory Care

Print ISSN: 0020-1324        Online ISSN: 1943-3654

© Daedalus Enterprises, Inc.

Powered by HighWire