Noninvasive Monitoring of Cardiac Output During Weaning From Mechanical Ventilation: A Pilot Study

Tanios, Maged; Epstein, Scott K.; Sauser, Sharon; Chi, Amy

doi:10.4037/ajcc2016921

Cited by 4 publications

(13 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In line with our explanation to the PPI change during SBT, Tanios et al had reported augmentation of the cardiac output during SBT in all patients which is more evident in patients with successful weaning [12]. Frazier et al had reported that the cardiac output increased significantly during the SBT in patients with successful weaning; whilst, no change was reported in the cardiac output in patients with failed weaning [11].…”

Section: Discussionsupporting

confidence: 85%

“…Thus, serial measurement of PPI could predict weaning failure. Switching the patient from assisted to spontaneous ventilation increases preload, afterload, and catecholamine release [11]; thus, it is usually associated with increased cardiac output [12] which would consequently increase the PPI. PPI reflects the adequacy of blood flow in the peripheral circulation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Peripheral perfusion index as a predictor of failed weaning from mechanical ventilation

Lotfy

Hasanin

Rashad

et al. 2020

J Clin Monit Comput

View full text Add to dashboard Cite

We hypothesized that impairment of peripheral perfusion index (PPI) during spontaneous breathing trial (SBT) might be predictive of weaning failure. We included 44 consecutive, adult, patients, who were scheduled for weaning after at least 48 h of invasive mechanical ventilation in this prospective observational study. Weaning failure was defined as failed SBT or reintubation within 48 h of extubation. PPI readings were obtained before initiation of the SBT, and every 5 min till the end of the SBT. PPI ratio was calculated at every time point as: PPI value/ baseline PPI. The primary outcome was the accuracy of PPI ratio at the end of the SBT in detecting failed weaning. Forty-three patients were available for the final analysis. Eighteen patients (42%) were considered failed weaning. PPI ratio was higher in patients with successful weaning compared to patients with failed weaning during the last 15 min of the SBT. PPI ratio at the end of SBT was higher in patients with successful weaning compared to patients with failed weaning. PPI ratio at the end of SBT had good predictive ability for weaning failure {area under receiver operating characteristic curve (95% confidence interval): 0.833(0.688-0.929), cutoff value ≤ 1.41}. The change in PPI during SBT is an independent predictor for re-intubation. PPI could be a useful tool for monitoring the patient response to SBT. Patients with successful weaning showed higher augmentation of PPI during the SBT compared to re-intubated patients. Failure of augmenting the PPI by 41% at the end of SBT could predict re-intubation with negative predictive value of 95%. Clinical trial identifier: NCT03974568. https ://clini caltr ials.gov/ct2/show/NCT03 97456 8?term=ahmed +hasan in&draw=3&rank=17

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Peripheral perfusion index as a predictor of failed weaning from mechanical ventilation

Lotfy

Hasanin

Rashad

et al. 2020

J Clin Monit Comput

View full text Add to dashboard Cite

show abstract

“…We examined the full texts of the remaining 22 studies in detail. Finally, nine articles [9][10][11][15][16][17][18][19][20] met the enrolment criteria and were included in our meta-analysis (Figure 1).…”

Section: Literature Search Resultsmentioning

confidence: 99%

“…Two studies focused on whose intubation was because of respiratory causes. 16,17 Three studies may be subject to review bias as it was unclear whether the investigators who made extubation decision were blind to the patient's weaning outcome and BNP levels. 15,17,18 We performed Egger's test (P = .274) and Begg's test (P = .274), and the results revealed that there was no obvious evidence to support publication bias in our meta-analysis.…”

Section: Study Quality and Publication Biasmentioning

confidence: 99%

Association between elevated brain natriuretic peptide levels and weaning failure: A systematic review and meta‐analysis

Tang

Zhao

et al. 2021

Int J Clin Pract

View full text Add to dashboard Cite

Objective: Cardiovascular dysfunction has been reported as an important mechanism of weaning failure, and recent data suggest that elevated brain natriuretic peptide (BNP) levels is associated with an increased risk of weaning failure. Therefore, we performed this meta-analysis to evaluate the correlation between elevated BNP levels and weaning failure in critically ill patients subject to mechanical ventilation.Methods: A systematic search in Cochrane Library, Embase, PubMed and Web of Science was performed up to September 25, 2019. Standard mean differences (SMD) and corresponding 95% confidence intervals (CIs) of the BNP levels were calculated for each study.Results: Nine studies with a total number of 589 were included in the final metaanalysis. The results showed that elevated BNP levels were significantly associated with the risk of weaning failure (SMD: 0.76, 95% CI: 0.47 to 1.05, P < .00001). The finding was consistent with the BNP measured before (SMD: 0.68, 95% CI: 0.26 to 1.11, P = .002) or at the end of spontaneous breathing trial (SBT) (SMD: 0.85, 95% CI: 0.52 to 1.18, P < .00001). Conclusions:This meta-analysis showed that increased plasma BNP concentration was associated with weaning failure in ICU patients.

show abstract

“…During weaning of mechanical ventilation, there is a usual increase in the cardiac output due to shifting the patient from positive to negative thoracic pressure (23). This increase in cardiac output is considered one of the predictors of successful weaning (23,24). This fact might explain the recent finding of the ability of the PPI to predict successful weaning (25).…”

Section: Other Uses Of Ppi In Critically Ill Patientsmentioning

confidence: 99%

Plethysmographic Peripheral Perfusion Index: Could It Be a New Vital Sign?

et al. 2021

View full text Add to dashboard Cite

The plethysmographic peripheral perfusion index (PPI) is a very useful parameter with various emerging utilities in medical practice. The PPI represents the ratio between pulsatile and non-pulsatile portions in peripheral circulation and is mainly affected by two main determinants: cardiac output and balance between sympathetic and parasympathetic nervous systems. The PPI decreases in cases of sympathetic predominance and/or low cardiac output states; therefore, it is a useful predictor of patient outcomes in critical care units. The PPI could be a surrogate for cardiac output in tests for fluid responsiveness, as an objective measure of pain especially in un-cooperative patients, and as a predictor of successful weaning from mechanical ventilation. The PPI is simple to measure, easy to interpret, and has continuously displayed variables, making it a convenient parameter for detecting the adequacy of blood flow and sympathetic-parasympathetic balance.

show abstract

Noninvasive Monitoring of Cardiac Output During Weaning From Mechanical Ventilation: A Pilot Study

Cited by 4 publications

References 30 publications

Peripheral perfusion index as a predictor of failed weaning from mechanical ventilation

Peripheral perfusion index as a predictor of failed weaning from mechanical ventilation

Association between elevated brain natriuretic peptide levels and weaning failure: A systematic review and meta‐analysis

Plethysmographic Peripheral Perfusion Index: Could It Be a New Vital Sign?

Contact Info

Product

Resources

About