2.50
Hdl Handle:
http://hdl.handle.net/10755/155583
Type:
Presentation
Title:
Work of Breathing During Weaning From Mechanical Ventilation
Abstract:
Work of Breathing During Weaning From Mechanical Ventilation
Conference Sponsor:Sigma Theta Tau International
Conference Year:2004
Conference Date:July 22-24, 2004
Author:Hu, Weihong, BS, MS
P.I. Institution Name:The Ohio State University
Title:Graduate Student
Co-Authors:Kathleen S. Stone, PhD, RN, FAAN; Susan Frazier, RN, PhD; Debra K. Moser, DNSc, RN
Introduction: Weaning from mechanical ventilation is a significant clinical problem with 37-45% of patients failing to wean. Long-term mechanical ventilation is associated with complications, mortality and increased cost of care in critically ill patients. Objective: The purpose of this study was to determine the effect of three different weaning modes (continuous positive airway pressure (CPAP), pressure support (PS) and t-piece on work of breathing (WOB) and the relationship of WOB and preload (blood volume) changes on cardiovascular-pulmonary (C-P) function during weaning from mechanical ventilation. Design: Experimental within subject repeated measures design. Subjects: This study was conducted in anesthetized male canines, Group I ([n=24], normal ventricular function) and Group II ([n=18], pace-maker induced heart failure). Methods: Subjects were randomly assigned to the two groups and the three weaning modes. WOB using the Bicore, arterial blood gases (ABGs) and three serial thermodilution cardiac output (CO) measurements at end-expiration were made before and after ventilator manipulation and preload changes (diuresis with lasix). Findings: In Group I,WOB was significantly less with PS (.7 joules/L, p=.007) than CPAP (1.28 joules/L) and T-piece (1.2 joules/L) p=.039. Following diuresis, WOB was significantly less with PS (.68 joules/L p=.000)than CPAP (1.18 joules/L) and T-piece (.98 joules/L) p=.004. In Group II heart failure, there were no statistically significant differences between the modes during hypervolemia. Following diuresis with lasix, WOB was significally less with PS (.58 joules/L p=.001 compared to CPAP (1.1joules/L). Alterations in cardiac output were least with PS and greatest with T-piece in groups I & II. Conclusions: Pressure support decreases the work of breathing with weaning and causes the least changes in cardiac output. T-piece causes marked alterations in CO increasing the risk of weaning failure. Implications: Weaning using pressure support ventilation is preferable in normal and heart failure subjects. Support: NIH NINR 1R01NR; American Nurses Foundation
Repository Posting Date:
26-Oct-2011
Date of Publication:
22-Jul-2004
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleWork of Breathing During Weaning From Mechanical Ventilationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/155583-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Work of Breathing During Weaning From Mechanical Ventilation</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July 22-24, 2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hu, Weihong, BS, MS</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The Ohio State University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Graduate Student</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">hu.116@osu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Kathleen S. Stone, PhD, RN, FAAN; Susan Frazier, RN, PhD; Debra K. Moser, DNSc, RN</td></tr><tr><td colspan="2" class="item-abstract">Introduction: Weaning from mechanical ventilation is a significant clinical problem with 37-45% of patients failing to wean. Long-term mechanical ventilation is associated with complications, mortality and increased cost of care in critically ill patients. Objective: The purpose of this study was to determine the effect of three different weaning modes (continuous positive airway pressure (CPAP), pressure support (PS) and t-piece on work of breathing (WOB) and the relationship of WOB and preload (blood volume) changes on cardiovascular-pulmonary (C-P) function during weaning from mechanical ventilation. Design: Experimental within subject repeated measures design. Subjects: This study was conducted in anesthetized male canines, Group I ([n=24], normal ventricular function) and Group II ([n=18], pace-maker induced heart failure). Methods: Subjects were randomly assigned to the two groups and the three weaning modes. WOB using the Bicore, arterial blood gases (ABGs) and three serial thermodilution cardiac output (CO) measurements at end-expiration were made before and after ventilator manipulation and preload changes (diuresis with lasix). Findings: In Group I,WOB was significantly less with PS (.7 joules/L, p=.007) than CPAP (1.28 joules/L) and T-piece (1.2 joules/L) p=.039. Following diuresis, WOB was significantly less with PS (.68 joules/L p=.000)than CPAP (1.18 joules/L) and T-piece (.98 joules/L) p=.004. In Group II heart failure, there were no statistically significant differences between the modes during hypervolemia. Following diuresis with lasix, WOB was significally less with PS (.58 joules/L p=.001 compared to CPAP (1.1joules/L). Alterations in cardiac output were least with PS and greatest with T-piece in groups I &amp; II. Conclusions: Pressure support decreases the work of breathing with weaning and causes the least changes in cardiac output. T-piece causes marked alterations in CO increasing the risk of weaning failure. Implications: Weaning using pressure support ventilation is preferable in normal and heart failure subjects. Support: NIH NINR 1R01NR; American Nurses Foundation</td></tr></table>en_GB
dc.date.available2011-10-26T13:58:40Z-
dc.date.issued2004-07-22en_GB
dc.date.accessioned2011-10-26T13:58:40Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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