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Effect of Tracheal Gas Insufflation During Weaning From Prolonged Mechanical Ventilation: A Preliminary Study

Authors :
Michael R. Pinsky
Leslie A. Hoffman
Edgar Delgado
Thomas G. Zullo
Frederick J. Tasota
Source :
American Journal of Critical Care. 12:31-39
Publication Year :
2003
Publisher :
AACN Publishing, 2003.

Abstract

• Background Tracheal gas insufflation reduces inspired tidal volume and minute ventilation in spontaneously breathing patients and may facilitate weaning from mechanical ventilation.• Objective To determine if tracheal gas insufflation can reduce ventilatory demand during weaning trials in patients who require prolonged mechanical ventilation.• Methods A reduction in ventilatory demand was defined as a relative decrease in tidal volume, minute ventilation, and mean inspiratory flow during trials with tracheal gas insufflation compared with the values during trials without this therapy. A total of 14 subjects underwent T-piece trials with and without insufflation (flow rate 6 L/min) on 2 consecutive days; the order of insufflation was randomized. Tidal volume, minute ventilation, and mean inspiratory flow were measured at baseline (without insufflation) and 2 hours later.• Results Differences in ventilatory demand were not significant when comparisons were made for condition (tracheal gas insufflation vs no flow) or time (baseline vs 2 hours) for the total group (P = .48). Subjects were classified post hoc as responders (n = 9) or nonresponders (n = 5). Comparisons between responders and nonresponders indicated a significant (P = .02) 3-way multivariate interaction for group (responder vs nonresponder), condition (tracheal gas insufflation vs no flow), and time (baseline vs 2 hours) for ventilatory demand variables.• Conclusion Tracheal gas insufflation can reduce ventilatory demand during weaning trials in some patients who require mechanical ventilation.

Details

ISSN :
1937710X and 10623264
Volume :
12
Database :
OpenAIRE
Journal :
American Journal of Critical Care
Accession number :
edsair.doi...........f9df36f54f4efff79ed5932370b99699
Full Text :
https://doi.org/10.4037/ajcc2003.12.1.31