Breathing pattern and workload during automatic tube compensation, pressure support and T-piece trials in weaning patients

Kuhlen, Ralf; Max, M.; Dembinski, Rolf; Terbeck, Sandra; Jürgens, E.; Rossaint, Rolf

doi:10.1097/00003643-200301000-00002

Cited by 27 publications

(8 citation statements)

References 22 publications

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“…Similar result was reported by Kuhlen et al [22], who compared PS 7 cmH 2 O and PEEP 7 cmH 2 O, ATC and PEEP 8 cmH 2 O and T-piece trial and PEEP 0 cmH 2 O in 12 patients undergoing SBT. It is worth mentioning that the investigators used a previous ventilator (Evita 4 vs. Evita XL in present study), endotracheal tubes much larger than in present study, the amount of R ET compensation was not indicated, and distribution of ventilation not assessed.…”

Section: Discussionsupporting

confidence: 89%

Low-pressure support vs automatic tube compensation during spontaneous breathing trial for weaning

Guérin

Terzi

Mezidi

et al. 2019

Ann. Intensive Care

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BackgroundDuring spontaneous breathing trial, low-pressure support is thought to compensate for endotracheal tube resistance, but it actually should provide overassistance. Automatic tube compensation is an option available in the ventilator to compensate for flow-resistance of endotracheal tube. Its effects on patient effort have been poorly investigated. We aimed to compare the effects of low-pressure support and automatic tube compensation during spontaneous breathing trial on breathing power and lung ventilation distribution.ResultsWe performed a randomized crossover study in 20 patients ready to wean. Each patient received both methods for 30 min separated by baseline ventilation: pressure support 0 cmH2O and automatic tube compensation 100% in one period and pressure support 7 cmH2O without automatic tube compensation in the other period, a 4 cmH2O positive end-expiratory pressure being applied in each. Same ventilator brand (Evita XL, Draeger, Germany) was used. Breathing power was assessed from Campbell diagram with esophageal pressure, airway pressure, flow and volume recorded by a data logger. Lung ventilation distribution was assessed by using electrical impedance tomography (Pulmovista, Draeger, Germany). During the last 2 min of low-pressure support and automatic compensation period breathing power and lung ventilation distribution were measured on each breath. Breathing power generated by the patient’s respiratory muscles was 7.2 (4.4–9.6) and 9.7 (5.7–21.9) J/min in low-pressure support and automatic tube compensation periods, respectively (P = 0.011). Lung ventilation distribution was not different between the two methods.ConclusionsWe found that ATC was associated with higher breathing power than low PS during SBT without altering the distribution of lung ventilation.

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Section: Discussionsupporting

confidence: 89%

Low-pressure support vs automatic tube compensation during spontaneous breathing trial for weaning

Guérin

Terzi

Mezidi

et al. 2019

Ann. Intensive Care

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“…A possible method to estimate the tube's crosssectional area noninvasively and therefore the WOB add is described elsewhere (42,43); however, we do not possess such a device. In line with these obvious limitations of ATC as currently realized in standard ventilators, Kuhlen and coworkers (44) found no difference in WOB between spontaneous breathing with a Tpiece or ATC, whereas PSV reduced WOB significantly. Since different ventilators may implement ATC in different ways, the results may vary when other commercially available ventilator are used.…”

Section: Discussionmentioning

confidence: 79%

Proportional assist versus pressure support ventilation in patients with acute respiratory failure: Cardiorespiratory responses to artificially increased ventilatory demand*

Varelmann

Wrigge

Zinserling

et al. 2005

Critical Care Medicine

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“…The simulator was programmed to breathe spontaneously. Oxygen consumption and lung compliance were varied to produce a range of tidal volumes, respiratory rates, and peak inspiratory flow rates similar to those of weaning patients [9]. Carbon dioxide production by the simulator was regulated according to a respiratory exchange ratio of 0.8; hence its value changed with oxygen consumption but stayed constant during measurement.…”

Section: Methodsmentioning

confidence: 99%

Performance of an oxygen delivery device for weaning potentially infectious critically ill patients*

So¹,

Gomersall

Chui

et al. 2004

Anaesthesia

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SummaryOxygen delivery via a heat and moisture exchange filter with an attached T-shaped reservoir satisfies infection control requirements of high efficiency bacterial and viral filtration and low gas flows. In order to assess the performance of such a device in critically ill patients being weaned from mechanical ventilation, we simulated 16 patients using a human patient simulator, measuring fractional inspired oxygen and carbon dioxide concentrations and work of breathing at three oxygen flow rates. Oxygen concentration was dependent on peak inspiratory flow rate, tidal volume and oxygen flow rate. Rebreathing, as indicated by inspired carbon dioxide concentration, was greatest at high respiratory rates and low tidal volumes. Imposed inspiratory work of breathing was relatively high (mean 0.88 J.l )1[SD 0.30]). We conclude that this method of oxygen delivery is only suitable for patients in whom rapid extubation is anticipated.

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Breathing pattern and workload during automatic tube compensation, pressure support and T-piece trials in weaning patients

Cited by 27 publications

References 22 publications

Low-pressure support vs automatic tube compensation during spontaneous breathing trial for weaning

Low-pressure support vs automatic tube compensation during spontaneous breathing trial for weaning

Proportional assist versus pressure support ventilation in patients with acute respiratory failure: Cardiorespiratory responses to artificially increased ventilatory demand*

Performance of an oxygen delivery device for weaning potentially infectious critically ill patients*

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