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| Name | Class |
|---|---|
| Unity Health Toronto | OTHER |
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The aim of this study was to compare the indices of rapid shallow breathing, neuromechanical efficiency (NME), and neuroventilatory efficiency (NVE) between patients being successfully extubated and those who failed weaning.
Patients, mechanically ventilated for > 24 h, were included when they met criteria for their first spontaneous breathing trial (SBT) on continuous positive airway pressure (CPAP) (5-6 cmH2O) for 30 minutes. Patients who did not fulfill the criteria for successful SBT, or required assist, or deceased within 48h post-extubation were considered extubation failure (F). Patients who completed the SBT and remained extubated > 48 h were considered successfully extubated (S). Before and during the SBT, arterial blood gases, heart, rate, blood pressure, and EAdi, flow, Vt, f, and, airway pressure (Paw) were measured. At 0, 5, 10, 15 and 30 minutes of the SBT, f/Vt, diaphragm electrical activity (EAdi), NME, and NVE were calculated. NME was calculated as Paw/EAdi during inspiratory occlusion. NVE was calculated as Vt/EAdi during unassisted inspirations.Arterial blood gases, heart rate, and blood pressure were measured. The receiver operating characteristic (ROC) curve was calculated to evaluate the predictive performance of each index.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Weaning failure | Weaning failure:(1) failed SBT; (2) reintubation and /or resumption of support following successful extubation; or (3) die 48h following extubation. | ||
| Weaning successful | Weaning successful:extubation and the absence of ventilatory support 48 h following the extubation |
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| Measure | Description | Time Frame |
|---|---|---|
| Neuroventilatory Efficiency (NVE) | NVE is the ratio of tidal volume and diaphragm electrical activity (Vt/EAdi).It is a value describing how effective a patient's breathing is. | at 30 minutes of the spontaneous breathing trials (SBT) |
| Measure | Description | Time Frame |
|---|---|---|
| Neuromechanical Efficiency (NME) | NME is the ratio between inspiratory pressure generation and EAdi (Paw/EAdi). | at 30 minutes of the spontaneous breathing trials (SBT) |
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Inclusion Criteria:
Exclusion Criteria:
(1) age <18 or >85 years, (2) tracheostomy, (3) treatment abandonment, (4) history of esophageal varices, (5) gastro-esophageal surgery in the previous 12 months or gastro-esophageal bleeding in the previous 30 days, (6) coagulation disorders (INR ratio>1.5 and APTT>44 s), (7) history of acute central or peripheral nervous system disorder or severe neuromuscular disease, (8) history of leukemia, severe chronic liver or chronic cardiac disease, (9) solid organ transplantation, (10) malignant tumor
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Patients who required mechanical ventilation for more than 24 h.
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| Name | Affiliation | Role |
|---|---|---|
| Haibo Qiu, MD, Phd | Southeast University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nanjing Zhong-Da Hospital | Nanjing | Jiangsu | 21009 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22849707 | Derived | Liu L, Liu H, Yang Y, Huang Y, Liu S, Beck J, Slutsky AS, Sinderby C, Qiu H. Neuroventilatory efficiency and extubation readiness in critically ill patients. Crit Care. 2012 Jul 31;16(4):R143. doi: 10.1186/cc11451. |
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Nasogastric tube Eligible patient was replaced with a modified EAdi catheter (Maquet, Solna, Sweden). Then the patients were switched to a Servo-i ventilator capable of processing signals of EAdi automatically.
In a 20 beds general ICU of a teaching hospital, from December 2008 to May 2010, 52 patients , mechanically ventilated for > 24 h, were included when they deemed ready for extubation by the clinical team and fulfilled established weaning criteria.
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| ID | Title | Description |
|---|---|---|
| FG000 | Weaning Failure | Weaning failure:(1) failed spontaneous breathing trials (SBT); (2) reintubation and /or resumption of support following successful extubation; or (3) die 48h following extubation. |
| FG001 | Weaning Successful | Weaning successful:extubation and the absence of ventilatory support 48 h following the extubation |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Weaning Failure | Weaning failure:(1) failed spontaneous breathing trials (SBT); (2) reintubation and /or resumption of support following successful extubation; or (3) die 48h following extubation. |
| BG001 | Weaning Successful |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Neuroventilatory Efficiency (NVE) | NVE is the ratio of tidal volume and diaphragm electrical activity (Vt/EAdi).It is a value describing how effective a patient's breathing is. | Posted | Mean | Standard Deviation | ml/uV | at 30 minutes of the spontaneous breathing trials (SBT) |
|
During the 30 nints of SBT, and 48 hours after extubation
There was no additional intervention being used in this observational study. We just observed the NVE and NME during a local protocol of SBT and weaning. In addition to the risk caused by the routine SBT and weaning, there was no additional risk during the observation period.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Weaning Failure | Weaning failure:(1) failed spontaneous breathing trials (SBT); (2) reintubation and /or resumption of support following successful extubation; or (3) die 48h following extubation. |
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Early termination leading to small numbers of subjects analyzed
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Haibo Qiu; Dr. Christer Sinderby | Department of Critical Care Medicine, Nanjing Zhong-Da Hospital, Southeast University School of Medicine, China | 008613951965301 | haiboq2000@yahoo.com.cn |
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| ID | Term |
|---|---|
| D012131 | Respiratory Insufficiency |
| D053120 | Respiratory Aspiration |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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Parameters of arterial blood gases, haemodynamic and mechanics of breathing
Weaning successful:extubation and the absence of ventilatory support 48 h following the extubation
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
|
| Units | Counts |
|---|---|
| Participants |
|
|
|
| Secondary | Neuromechanical Efficiency (NME) | NME is the ratio between inspiratory pressure generation and EAdi (Paw/EAdi). | Posted | Mean | Standard Deviation | cmH2O/uV | at 30 minutes of the spontaneous breathing trials (SBT) |
|
|
|
|
| 0 |
| 17 |
| 0 |
| 17 |
| EG001 | Weaning Successful | Weaning successful:extubation and the absence of ventilatory support 48 h following the extubation | 0 | 35 | 0 | 35 |
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