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- Title
Kinetics of oxygen uptake during unassisted breathing trials in prolonged mechanical ventilation: a prospective pilot study.
- Authors
Lee, I-Hsien; Kuo, Yao-Wen; Lin, Feng-Ching; Wu, Chang-Wei; Jerng, Jih-Shuin; Kuo, Ping-Hung; Cheng, Jui-Chen; Chien, Ying-Chun; Huang, Chun-Kai; Wu, Huey-Dong
- Abstract
Few studies have investigated the measurement of oxygen uptake ( V ˙ O2) in tracheostomized patients undergoing unassisted breathing trials (UBTs) for liberation from mechanical ventilation (MV). Using an open-circuit, breath-to-breath method, we continuously measured V ˙ O2 and relevant parameters during 120-min UBTs via a T-tube in 49 tracheostomized patients with prolonged MV, and calculated mean values in the first and last 5-min periods. Forty-one (84%) patients successfully completed the UBTs. The median V ˙ O2 increased significantly (from 235.8 to 298.2 ml/min; P = 0.025) in the failure group, but there was no significant change in the success group (from 223.1 to 221.6 ml/min; P = 0.505). In multivariate logistic regression analysis, an increase in V ˙ O2 > 17% from the beginning period (odds ratio [OR] 0.084; 95% confidence interval [CI] 0.012–0.600; P = 0.014) and a peak inspiratory pressure greater than − 30 cmH2O (OR 11.083; 95% CI 1.117–109.944; P = 0.04) were significantly associated with the success of 120-min UBT. A refined prediction model combining heart rate, energy expenditure, end-tidal CO2 and oxygen equivalent showed a modest increase in the area under the receiver operating characteristic curve of 0.788 (P = 0.578) and lower Akaike information criterion score of 41.83 compared to the traditional prediction model including heart rate and respiratory rate for achieving 48 h of unassisted breathing. Our findings show the potential of monitoring V ˙ O2 in the final phase of weaning in tracheostomized patients with prolonged MV.
- Subjects
ANALYTICAL mechanics; AEROBIC capacity; RESPIRATION; ARTIFICIAL respiration; TRACHEOTOMY patients
- Publication
Scientific Reports, 2020, Vol 10, Issue 1, pN.PAG
- ISSN
2045-2322
- Publication type
Article
- DOI
10.1038/s41598-020-71278-2