INFLUENCE OF DURATION OF HYPERVENTILATION ON RISE TIME OF Pco2 AFTER STEP REDUCTION OF VENTILATION

Ivanov, S.D.; Nunn, J.F.; Little, David M.

doi:10.1097/00132586-197006000-00001

Survey of Anesthesiology

1970

DOI: 10.1097/00132586-197006000-00001

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INFLUENCE OF DURATION OF HYPERVENTILATION ON RISE TIME OF Pco2 AFTER STEP REDUCTION OF VENTILATION

S.D. Ivanov

J.F. Nunn

David M. Little

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2019

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“…PaCO 2 changes slowly and reaches steady state when the minute volume is altered, unlike changes in PaO 2 . Therefore, more time is needed than the time for PaO 2 to reflect adequate gas exchange to determine if patients can maintain adequate carbon dioxide removal with mechanical ventilation after weaning from ECMO 15,16. However, in our study, a significant change in PaCO 2 was identified only within the first hour after trial off, while changes in PaO 2 were also observed at 2 h.…”

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Duration of sweep gas off trial for weaning from venovenous extracorporeal membrane oxygenation

Choi

Chung

et al. 2019

Ther Adv Respir Dis

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Background:No data are available on the duration of time needed to assess the adequacy of lung function after stopping sweep gas for weaning of venovenous extracorporeal membrane oxygenation (ECMO). The objective of this study was to investigate changes in arterial blood gases (ABGs) during sweep gas off trials in patients receiving venovenous ECMO.Methods:Data on patients receiving venovenous ECMO, with a weaning trial at least once, were collected prospectively from January 2012 through December 2017. Serial changes in ABGs during sweep gas off trial and clinical outcomes after weaning from venovenous ECMO were evaluated.Results:Over the study period, 192 sweep gas off trials occurred in 93 patients: 115 (60%) failed and 77 (40%) were successful. During the trial, significant changes in blood gases were observed within 1 h in all patients. When serial ABGs were compared according to trial off results, there were no significant differences in the pH, PaCO2, and HCO3− trends across time points between successful and failed trials. However, PaO2 (70.6 versus 93.4 mmHg), SaO2 (91.9 versus 95.2%), and PaO2/FiO2 ratio (164.0 versus 233.4) were significantly lower in failed trials than successful trials within 1 h after stopping sweep gas. After 2 h of trial off, no significant change in blood gases was observed until the end of the trial.Conclusions:No change in blood gases was observed 2 h after stopping sweep gas in patients receiving venovenous ECMO. Based on our institutional experience, however, we suggest monitoring for 2 h or more after stopping sweep gas flow to assess if patients are ready for decannulation. The reviews of this paper are available via the supplemental material section.

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confidence: 99%

Duration of sweep gas off trial for weaning from venovenous extracorporeal membrane oxygenation

Choi

Chung

et al. 2019

Ther Adv Respir Dis

View full text Add to dashboard Cite

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INFLUENCE OF DURATION OF HYPERVENTILATION ON RISE TIME OF Pco2 AFTER STEP REDUCTION OF VENTILATION

Cited by 1 publication

References 0 publications

Duration of sweep gas off trial for weaning from venovenous extracorporeal membrane oxygenation

Duration of sweep gas off trial for weaning from venovenous extracorporeal membrane oxygenation

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