Chest
Clinical InvestigationsComparison of Standard Weaning Parameters and the Mechanical Work of Breathing in Mechanically Ventilated Patients
Section snippets
METHODS
We studied 17 general medical and surgical intensive care unit (ICU) patients at the Tucson Veterans Administration Medical Center. All patients required intubation and mechanical ventilation for respiratory failure due to pulmonary parenchymal disease. Patients entered the study when they were medically stable with correction of hemodynamic instability, anemia, sepsis, acid/base and electrolyte abnormalities, and altered mental status and when oxygenation was adequate (arterial oxygen pressure
RESULTS
The 17 patients studied ranged in age from 51 to 78 years (mean: 65 years). They were grouped as follows (Table 1): Group 1 included 11 patients who were successfully extubated within 24 hs of study entry and were generally ventilated for a brief time period (range: 22 to 72 hs; mean: 45 hs). Group 2 included six patients who required mechanical ventilation for longer than 24 hs from study entry and were studied on several occasions until successful extubation or death (one case). Time from
DISCUSSION
Our results confirm that satisfaction of conventional mechanical weaning criteria is often associated with weaning success in those patients requiring short periods of mechanical ventilation. However, in our patients requiring prolonged mechanical support, these criteria do not clearly distinguish times of ventilator dependence from those of successful weaning and extubation. The inspiratory work of spontaneous breathing is a better indicator of successful weaning.
Conventional mechanical
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Cited by (0)
Supported by the Veterans Administration.
Manuscript received September 14; revision accepted January 21.