The difficult task of searching for tools that help predict mechanical ventilator weaning success

Pinheiro, Bruno Valle

doi:10.1590/s1806-37562017000400001

Cited by 2 publications

(3 citation statements)

References 11 publications

(8 reference statements)

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“…Disorders of neuromuscular transmission such as myasthenia gravis and Lambert-Eaton syndrome as well as myopathies, muscular dystrophies, and metabolic or immunologic disorders can cause DD. [11][12][13][14] Research aimed at this topic has focused on investigating the prevalence of DD and its association with weaning failure in the critical care population; however, we are not aware of any studies to date that highlight the impact of DD among PMV patients in the LTACH setting. With the aging US population, demand for intensivist services is predicted to increase by 38% over the next decade.…”

Section: What Is Newmentioning

confidence: 99%

“…In addition, phrenic nerve dysfunction linked to head and neck cancer, such as recurrent laryngeal carcinoma, can cause DD. Disorders of neuromuscular transmission such as myasthenia gravis and Lambert-Eaton syndrome as well as myopathies, muscular dystrophies, and metabolic or immunologic disorders can cause DD 11–14 . Research aimed at this topic has focused on investigating the prevalence of DD and its association with weaning failure in the critical care population; however, we are not aware of any studies to date that highlight the impact of DD among PMV patients in the LTACH setting.…”

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confidence: 99%

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Prevalence of Diaphragmatic Dysfunction in the Long-Term Acute Care Setting and Its Effects on Ventilator Weaning Outcomes

Barchuk

Roebken

et al. 2021

Am J Phys Med Rehabil

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Objective: To determine the prevalence of undiagnosed diaphragmatic dysfunction in a long-term acute care hospital setting in patients on prolonged mechanical ventilation and its association with weaning outcomes. Design: This is a single-center, retrospective cohort study including 451 patients on prolonged mechanical ventilation admitted to a longterm acute care hospital facility between 2012 and 2017. Diaphragmatic dysfunction was assessed using fluoroscopy. Results: Three hundred nineteen patients on prolonged mechanical ventilation were assessed for diaphragmatic dysfunction. Nine patients were diagnosed with diaphragmatic dysfunction before admission. Eighty (72.7%) without diaphragmatic dysfunction were successfully weaned and 30 (27.3%) failed to wean, whereas 51 participants (31.9%) with diaphragmatic dysfunction were successfully weaned and 109 (68.1%) failed to wean (P < 0.001). When analyzing days to wean, the median was 13 days for those with no diaphragmatic dysfunction, 19 days with unilateral diaphragmatic dysfunction, and 28 days with bilateral diaphragmatic dysfunction (P < 0.001). Weaning success was not statistically associated with generalized neuromuscular disorders, age, sex, body mass index, smoking history, or diabetes. Conclusions: Diaphragmatic dysfunction was found to be strongly associated with time to wean and weaning success in the long-term acute care hospital setting. Very few patients despite being on prolonged mechanical ventilation were diagnosed with diaphragmatic dysfunction before longterm acute care hospital admission. Given this information, early diagnosis of diaphragmatic dysfunction among prolonged mechanical ventilation patients in the long-term acute care hospital setting is paramount in preventing secondary complications associated with mechanical ventilation.

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Section: What Is Newmentioning

confidence: 99%

mentioning

confidence: 99%

Prevalence of Diaphragmatic Dysfunction in the Long-Term Acute Care Setting and Its Effects on Ventilator Weaning Outcomes

Barchuk

Roebken

et al. 2021

Am J Phys Med Rehabil

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“…Um dos principais recursos utilizados na Unidade de Terapia Intensiva (UTI) é a ventilação mecânica invasiva (VMI), sendo esta imprescindível para a manutenção da vida em determinadas situações como no caso da insuficiência respiratória aguda e crônico agudizada. Ela está associada a várias complicações, sendo recomendada a retirada do paciente da ventilação mecânica (VM) o mais precoce possível, ou seja, assim que a causa da intubação tenha sido resolvida e a condição clínica do paciente permitir (Barbas et al, 2014;Pinheiro, 2017).…”

Section: Introductionunclassified

Principais Causas De Falha Na Extubação De Pacientes Internados Em Um Centro De Terapia Intensiva Adulto De Um Hospital Do Interior De Minas Gerais

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Nogueira

Machado³

2020

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A ventilação mecânica (VM) ou suporte ventilatório é considerado um método de tratamento vital nas (UTIs). Ademais é tido como um valioso suporte no atendimento de paciente com insuficiência respiratória aguda e crônica agudizada. Há evidências de que, quanto antes seja estabelecida a condição clínica desse paciente, de acordo como protocolo mais breve será a sua extubação. O objetivo dessa pesquisa foi determinar as principais causas de falha na extubação em pacientes de um centro de terapia intensiva adulto (CTI). O estudo realizado foi do tipo descritivo, retrospectivo e longitudinal, foram analisados 58 prontuários de pacientes que estiveram internados no CTI de um hospital do interior de Minas Gerais. A amostra foi composta por 58 pacientes, sendo 32 homens e 26 mulheres, desses 23 foram a óbito. O principal diagnóstico clínico foi doenças neurológicas seguida de doenças respiratórias. A principal causa de falha da extubação no sexo feminino foi por laringoespasmo; aumento do trabalho respiratório; e rebaixamento do nível de consciência associado ao aumento do trabalho respiratório. No sexo masculino foi por insuficiência respiratória; rebaixamento do nível de consciência associado ao aumento do trabalho respiratório. O estudo, perfez-se que dos prontuários analisados 23 destes evoluíram para óbito. O tempo que o paciente permaneceu em ventilação mecânica corresponde a 5 dias. Nove pacientes do sexo feminino e seis do sexo masculino, foram considerados inaptos pelo protocolo e extubados, destes, 5 pacientes evoluíram para óbito, o que mostra a falta de adesão, e a resistência da equipe em seguir protocolos.

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The difficult task of searching for tools that help predict mechanical ventilator weaning success

Cited by 2 publications

References 11 publications

Prevalence of Diaphragmatic Dysfunction in the Long-Term Acute Care Setting and Its Effects on Ventilator Weaning Outcomes

Prevalence of Diaphragmatic Dysfunction in the Long-Term Acute Care Setting and Its Effects on Ventilator Weaning Outcomes

Principais Causas De Falha Na Extubação De Pacientes Internados Em Um Centro De Terapia Intensiva Adulto De Um Hospital Do Interior De Minas Gerais

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