Is Optimal Minute Ventilation a Predictor of Weaning in Patients With Prolong Mechanical Ventilation?

Taipei Tzu Chi Hospital , Buddhist Tzu Chi Medical Foundation

1. purpose of study: optimal minute could be the prediction of successful weaning and become the new weaning parameter.

2. study design: inclusion criteria: investigators will perform this study at our respiratory care center. Patients who had been maintained on mechanical ventilator in excess of 3 weeks before respiratory care center admission and all previous weaning attempts had ailed.

   Exclusion criteria: Patients do not have spontaneous breath. Terminal cancer stage and unstable hemodynamics condition.

3. study duration: 2016/01/01~12/31

Investigators will preform this study at our respiratory care center. Initially, Investigators collected all physiological parameters and baseline characteristics of patients with prolong mechanical ventilator. Investigators use Gold-Galileo ventilator and patients use adaptive support ventilation mode. In adaptive support ventilation, the clinician enters a target minute volume , using a parameter called minute ventilation percentage. The minute ventilation percentage setting be initially set at 100% (the 100%minute ventilation setting), which provides a target minute ventilation of 0.1 L/min/kg of ideal body weight . Investigators observed respiratory frequency of patients, the minute ventilation percentage was increased every 5 min until the mandatory breath began to appear and spontaneous rate is zero. If the minute ventilation percentage had exceeded 250%, but patients do not have mandatory rate appeared, the optimal minute ventilation of the patient is means above 250%. Investigators also measure other weaning parameters. Finally, Investigators analyze the prediction of optimal minute ventilation as a weaning parameter.

Inclusion Criteria:

• patients who had been maintained on mechanical ventilation in excess of 3 weeks before respiratory care center admission and all previous weaning attempts had failed.

Exclusion Criteria:

• Patients do not have spontaneous breath. Patients do not use invasive mechanical ventilator. Terminal cancer stage and hemodynamics unstable.