A Comparison of Clinical Efficacy of Weaning Method Between the Mode of Intermittent Mandatory Ventilation and Intermittent Mandatory Ventilation Plus Pressure Support .
10.4046/trd.1994.41.4.372
- Author:
Jeong Eun CHOI
;
Youn Suck KOH
;
Won Kyoung CHO
;
Chae Man LIM
;
Woo Sung KIM
;
Won Dong KIM
;
Pyung Hwan PARK
;
Jong Moo CHOI
- Publication Type:Original Article
- Keywords:
Weaning;
Pressure support ventilation
- MeSH:
APACHE;
Blood Gas Analysis;
Blood Pressure;
Heart Rate;
Humans;
Nutritional Status;
Respiration, Artificial;
Respiratory Rate;
Ventilation*;
Weaning*
- From:Tuberculosis and Respiratory Diseases
1994;41(4):372-378
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Pressure support ventilation(PSV) is a new form of mechanical ventilatory support that assists spontaneous inspiratory effort of an intubated patient with a clinician-selected amount of positive airway pressure. Low level pressure support during inspiration can overcome the resistive component of inspiratory work imposed by ah endotracheal tube. However the clinical efficacy of PSV as a weaning method has not been established yet. Object : The aim of study was to evaluate the efficacy of PSV when it is added to intermittent mandatory ventilation (IMV) in facilitating weaning process compared to IMV mode alone. METHOD: When the subject patients became clinically stable with their arterial blood gas analysis in acceptable range, they underwent weaning process either by IMV alone or by IMV plus PSV. The level of pressure support was held constant through the weaning period. For the patients who required mechanical ventilation for less than 72hr, 2h weaning trial was performed with IMV rate starting from 6/min. For the patients who required mechanical ventilation more than 72 hr, 7 hr weaning retrial was performed with IMV rate starting from 8/min. For the patients who failed three consecutive trials of weaning, retrial of weaning was attempted over 3 days with IMV rate starting from 8/min. Clinical characteristics, APACHE II score and nutritional status were compared. For all patients, heart rate, mean blood pressure and respiratory rate were mornitored for 48 hrs after weaning trial started. RESULTS: The total number of weaning trial was 37 in 23 patients(18 by IMV, 19 by IMV+PSV). Total ventilation time, APACHE II score and nutritional status were not statistically different between the two groups. The weaning success rate were not statistically different(38.3% by IMV, 42.1% by IMV+PSV) and the changes of mean blood pressure, heart rate, respiratory rate during first 48 hours were not different between the two groups. CONCLUSION: Low level PSV when added to IMV for weaning trial does not seem to improve the success rate of weaning from mechanical ventilation. PSV at 10cm H2O did not induce significant physiologic changes during weaning process.
