The effect of high-flow oxygen via tracheostomy on respiratory pattern and diaphragmatic function in patients with prolonged mechanical ventilation: A randomized, physiological, crossover study

Lytra, Elena; Kokkoris, Stelios; Poularas, Ioannis; Filippiadis, Dimitrios; Cokkinos, Demosthenes; Exarhos, Dimitrios; Zakynthinos, Spyros; Routsi, Christina

doi:10.1016/j.jointm.2023.11.008

Journal of Intensive Medicine

2024

DOI: 10.1016/j.jointm.2023.11.008

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The effect of high-flow oxygen via tracheostomy on respiratory pattern and diaphragmatic function in patients with prolonged mechanical ventilation: A randomized, physiological, crossover study

Elena Lytra,

Stelios Kokkoris,

Ioannis Poularas

et al.

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Cited by 3 publications

References 34 publications

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High flow in tracheostomized patients on their first attempt to wean from mechanical ventilation: more questions on the table

Gallardo,

Silvero,

Saavedra

2025

Medicina Intensiva

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High flow in tracheostomized patients on their first attempt to wean from mechanical ventilation: more questions on the table

Gallardo,

Silvero,

Saavedra

2025

Medicina Intensiva

View full text Add to dashboard Cite

High flow in tracheostomized patients on their first attempt to wean from mechanical ventilation: more questions on the table

Gallardo,

Silvero,

Saavedra

2024

Medicina Intensiva (English Edition)

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Effects of different VV ECMO blood flow rates on lung perfusion assessment by hypertonic saline bolus-based electrical impedance tomography

Zhang,

Wu,

Gao

et al. 2024

Crit Care

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Objective Our study aimed to investigate the effects of different extracorporeal membrane oxygenation (ECMO) blood flow rates on lung perfusion assessment using the saline bolus-based electrical impedance tomography (EIT) technique in patients on veno-venous (VV) ECMO. Methods In this single-centered prospective physiological study, patients on VV ECMO who met the ECMO weaning criteria were assessed for lung perfusion using saline bolus-based EIT at various ECMO blood flow rates (gradually decreased from 4.5 L/min to 3.5 L/min, 2.5 L/min, 1.5 L/min, and finally to 0 L/min). Lung perfusion distribution, dead space, shunt, ventilation/perfusion matching, and recirculation fraction at different flow rates were compared. Results Fifteen patients were included. As the ECMO blood flow rate decreased from 4.5 L/min to 0 L/min, the recirculation fraction decreased significantly. The main EIT-based findings were as follows. (1) Median lung perfusion significantly increased in region-of-interest (ROI) 2 and the ventral region [38.21 (34.93–42.16)% to 41.29 (35.32–43.75)%, p = 0.003, and 48.86 (45.53–58.96)% to 54.12 (45.07–61.16)%, p = 0.037, respectively], whereas it significantly decreased in ROI 4 and the dorsal region [7.87 (5.42–9.78)% to 6.08 (5.27–9.34)%, p = 0.049, and 51.14 (41.04–54.47)% to 45.88 (38.84–54.93)%, p = 0.037, respectively]. (2) Dead space significantly decreased, and ventilation/perfusion matching significantly increased in both the ventral and global regions. (3) No significant variations were observed in regional and global shunt. Conclusions During VV ECMO, the ECMO blood flow rate, closely linked to recirculation fraction, could affect the accuracy of lung perfusion assessment using hypertonic saline bolus-based EIT.

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The effect of high-flow oxygen via tracheostomy on respiratory pattern and diaphragmatic function in patients with prolonged mechanical ventilation: A randomized, physiological, crossover study

Cited by 3 publications

References 34 publications

High flow in tracheostomized patients on their first attempt to wean from mechanical ventilation: more questions on the table

High flow in tracheostomized patients on their first attempt to wean from mechanical ventilation: more questions on the table

High flow in tracheostomized patients on their first attempt to wean from mechanical ventilation: more questions on the table

Effects of different VV ECMO blood flow rates on lung perfusion assessment by hypertonic saline bolus-based electrical impedance tomography

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