CO<sub>2</sub>Response and Duration of Weaning From Mechanical Ventilation

Raurich, J. M.; Rialp, Gemma; Ibáñez, J.; Llompart-Pou, J.A.; Ayestarán, Ignacio

doi:10.4187/respcare.01080

Cited by 12 publications

(12 citation statements)

References 34 publications

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“…9 Half of our patients with cervical SCI had values of hypercapnic drive response equal or lower than 0.19 cm H 2 O per mm Hg, a value associated with prolonged weaning of mechanical ventilation in critically ill patients. 4 We believe that, along with the respiratory muscle paralysis, the reduced hypercapnic drive response to CO 2 may contribute to the difficult weaning of mechanical ventilation observed in cervical SCI patients.…”

Section: Discussionmentioning

confidence: 95%

“…4 Thus, these patients may benefit from early tracheostomy. Unfortunately, most of our cervical SCI patients were transferred to referral long-term rehabilitation hospitals in their country of origin connected to the ventilator, making follow-up impossible.…”

Section: Discussionmentioning

confidence: 99%

“…CO 2 response test was conducted in both groups of patients. To increase the CO 2 , we used the method of re-inhalation of expired air 3,4 Baseline values for CO 2 response test were obtained after applying 5 min of pressure support ventilation with a pressure of 7 cm H 2 O without positive endexpiratory pressure, and FiO 2 was set at 1.0 to prevent hypoxemia for patients' security and to avoid hypoxic stimuli. Then, breathing frequency, P 0.1 and V E were recorded from the ventilator, and an arterial blood sample was withdrawn.…”

Section: Measurements and Proceduresmentioning

confidence: 99%

“…3,4 Any alteration of the respiratory system (metabolic control, neuromuscular or ventilatory apparatus) can reduce the hypercapnic ventilatory response, whereas reduced hypercapnic drive response indicates an alteration in the chemosensitivity of the respiratory center.…”

Section: Introductionmentioning

confidence: 99%

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Respiratory CO2 response in acute cervical spinal cord injury (CO2 response in spinal cord injury)

et al. 2013

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Study design: Retrospective study. Objectives: The objective of this study was to compare the CO 2 response of acute tetraplegic cervical spinal cord injury (SCI) patients undergoing mechanical ventilation with a control group of critically ill patients ready for weaning of mechanical ventilation and successfully extubated. Setting: This study was conducted at the intensive care unit of a University Hospital in Mallorca, Spain. Methods: CO 2 response was studied in 12 acute tetraplegic cervical SCI patients at the C4 ÀC7 level and 22 control patients. The control group patients were consecutively selected from a database of patients with mechanical ventilation and who were successfully extubated after a CO 2 response test. To increase the CO 2 , we used the method of re-inhalation of expired air, and we evaluated the hypercapnic ventilatory response, the change in minute ventilation induced by the increase of partial pressure of arterial carbon dioxide (PaCO 2 ), which measures the whole respiratory system (metabolic control, neuromuscular or ventilatory apparatus), and the hypercapnic drive response, the change in the airway occlusion pressure at 100 ms induced by the increase in PaCO 2 , which measures the chemosensitivity of the respiratory center. Results: Cervical SCI patients were younger than the control group patients (26±7 and 62±12 years, respectively; Po0.001). Mean values of the hypercapnic ventilatory response in cervical SCI and control groups were 0.52±0.31 and 0.64±0.33 l min À1 per mm Hg (P ¼ 0.40), respectively, and the hypercapnic drive response was 0.24 ± 0.16 and 0.48 ± 0.23 cm H 2 O per mm Hg (P ¼ 0.001), respectively. Conclusion: Acute tetraplegic cervical SCI patients had reduced hypercapnic drive response that may contribute to the difficult weaning, without reduction in hypercapnic ventilatory response.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Measurements and Proceduresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Respiratory CO2 response in acute cervical spinal cord injury (CO2 response in spinal cord injury)

et al. 2013

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“…We considered a value Յ 26 Duration of mechanical ventilation before the study day was defined as the number of days between the beginning of mechanical ventilation and the day the CO 2 response test was performed. Subjects were followed until discharge from our 2 hospitals.…”

Section: Data Collection and Definitionsmentioning

confidence: 99%