Important step of weaning from mechanical ventilation: accurate assessment of respiratory muscle strength
10.3760/cma.j.cn121430-20231120-00991
- VernacularTitle:机械通气脱机重要环节
- Author:
Yingzhi QIN
1
;
Xinjing GAO
Author Information
1. 天津第三中心医院重症医学科，天津 300170
- Keywords:
Mechanical ventilation;
Weaning;
Spontaneous breathing trail;
Rapid shallow breathing index;
Maximal inspiratory pressure;
Integrative weaning index
- From:
Chinese Critical Care Medicine
2024;36(4):337-339
- CountryChina
- Language:Chinese
-
Abstract:
Mechanical ventilation (MV) is a powerful mean to rescue patients with respiratory failure. In view of the different etiology and basic respiratory function of patients with respiratory failure, weaning failure often occurs. Prolonged MV time is often accompanied by many complications. Thus, deeply understanding the pathophysiological changes of respiratory failure and strengthen monitoring of respiratory mechanics are helpful to optimize MV parameter settings, reduce ventilator-induced lung injury and wean from MV as early as possible. A successful weaning from MV depends on many factors, the most important factors are respiratory muscle strength, respiratory load and respiratory drive. Spontaneous breathing trial (SBT) is an important part of weaning process. The main purpose of implementing SBT is to screen patients and opportunities to weaning from MV, and find reversible reasons for not passing SBT. Because the accuracy of SBT in assessing weaning prognosis is about 85%, it is not adequate for difficult weaning patients. Standardized measurement of weaning indicators for patients with difficulty weaning is conducive to accurate assessment of respiratory muscle strength and improve the success rate of weaning from MV.
