Duration of mechanical ventilation on the result of diaphragmatic function in weaning

Hb Qiu,W Guo,Y Yang

doi:10.1186/cc9580

Abstract

Objective To investigate the influence of duration of mechanical ventilation on the diaphragmatic function.Methods Patients included in this study were those who mechanically ventilated for at least 24 h and were preparing to wean from December 2008 to December 2009 in ICU of Nanjing Zhong da Hospital.Patients,according to the duration of mechanical ventilation,were divided into group A (ventilated less than three days) and group B (ventilated more than three days).30 min Spontaneous breathing test (SBT) was carried on the patients satisfying the weaning permission.Indices of diaphragm function,such as electrical activity of diaphragm (Edi),neuro-muscular strength index ( NMS),neuromechanical coupling (NMC) and neuro-ventilatory coupling (NVC) at 0 min,5 min and 30 min of SBT were monitored.Results 44 patients were included finally,of whom 19 patients (43.2％) ventilated more than three days (group B).44 patients ventilated less than three days (group A).①There was no significant difference in Edi,NMS,NMC or NVC at 0 min of SBT between the two groups.②Edi and NMS in group B were largely more than group A at 5 min of SBT.③At SBT 30 min,Edi and NMS in group B both were significantly higher than group A [( 23 ± 11 ) μV vs ( 15 ± 8) μV,( 598 ± 309) μV ·cpm vs (363±224) μV · cpm,P ＜0.05].Whereas,NVC in group B was lower than group A ( P ＜0.05).Conclusions The contractility and endurance of diaphragm decreased in patients whom ventilated more than three days at 30 min of SBT.It seemed that incremental duration of mechanical ventilation could exacerbate the diaphragm dysfunction,which might be one of the important factors leading to failed weaning. Key words: Duration of mechanical ventilation; Diaphragm function; Electrical activity of diaphragm; Neuro-muscular strength index; Neuro-mechanical coupling; Neuro-ventilatory coupling

Highlights

In this study we aimed to investigate the relationship between thyroid hormone abnormalities and major cardiovascular events and sudden cardiac death at 3 and 6 months after discharge in patients who were admitted to the Emergency Department with acute coronary syndrome
The aim of this study was to demonstrate the role of arginase and adenosine deaminase (ADA) in patients suffering from myocardial infarction (MI), and in a group of patients with chronic renal failure (CRF) with cardiovascular diseases (CVD)
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Summary

Introduction

Results We studied 53 patients (42 males, mean age (SEM) 57.6 (2.8) years, illness severity scores APACHE II 21.3 (0.9); SAPS II 53.3 (2.3); SOFA 10.2 (0.2); and ICU stay 35.9 (4.8) days). Results We included 53 consecutive patients (42 males, mean age 57.6 ± 2.8 years, illness severity scores APACHE II 21.3 ± 0.9; SAPS II 53.3 ± 2.3; SOFA 10.2 ± 0.2; and mean ICU stay 35.9 ± 4.8 days) of which 25 (47.2%) had at least one US findings. The objective of this study was to determine the incidence and type of incidents related to intrahospital transport (IHT) of critically ill patients in our ICU and to identify contributing factors of these incidents. The aim of this study was to assess the effect of monotherapy with nebulized colistin on clinical and microbiological outcomes in critically ill patients with VAT due to polymyxin-only susceptible Gram-negative bacteria

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