An observational study in Respiratory Failure, sponsored by Southeast University, China. Completed at 1 site in China. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2011-08-31.
Sponsored by Southeast University, China · Observational
The aim of this study was to compare the indices of rapid shallow breathing, neuromechanical efficiency (NME), and neuroventilatory efficiency (NVE) between patients being successfully extubated and those who failed weaning.
Patients, mechanically ventilated for > 24 h, were included when they met criteria for their first spontaneous breathing trial (SBT) on continuous positive airway pressure (CPAP) (5-6 cmH2O) for 30 minutes. Patients who did not fulfill the criteria for successful SBT, or required assist, or deceased within 48h post-extubation were considered extubation failure (F). Patients who completed the SBT and remained extubated > 48 h were considered successfully extubated (S). Before and during the SBT, arterial blood gases, heart, rate, blood pressure, and EAdi, flow, Vt, f, and, airway pressure (Paw) were measured. At 0, 5, 10, 15 and 30 minutes of the SBT, f/Vt, diaphragm electrical activity (EAdi), NME, and NVE were calculated. NME was calculated as Paw/EAdi during inspiratory occlusion. NVE was calculated as Vt/EAdi during unassisted inspirations.Arterial blood gases, heart rate, and blood pressure were measured. The receiver operating characteristic (ROC) curve was calculated to evaluate the predictive performance of each index.
1,650 studies on the registry are indexed under Respiratory Insufficiency; 296 are open to participants now.
This study's enrollment of 52 is below the median of 100 across 545 observational studies indexed under Respiratory Insufficiency.
Browse Respiratory Insufficiency studies →Southeast University, China is the lead sponsor of 164 studies on the registry; 44 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Patients who required mechanical ventilation for more than 24 h.
Exclusion Criteria:
(1) age \<18 or >85 years, (2) tracheostomy, (3) treatment abandonment, (4) history of esophageal varices, (5) gastro-esophageal surgery in the previous 12 months or gastro-esophageal bleeding in the previous 30 days, (6) coagulation disorders (INR ratio>1.5 and APTT>44 s), (7) history of acute central or peripheral nervous system disorder or severe neuromuscular disease, (8) history of leukemia, severe chronic liver or chronic cardiac disease, (9) solid organ transplantation, (10) malignant tumor
Weaning failure:(1) failed SBT; (2) reintubation and /or resumption of support following successful extubation; or (3) die 48h following extubation.
Weaning successful:extubation and the absence of ventilatory support 48 h following the extubation
Neuroventilatory Efficiency (NVE)
NVE is the ratio of tidal volume and diaphragm electrical activity (Vt/EAdi).It is a value describing how effective a patient's breathing is.
Time frame: at 30 minutes of the spontaneous breathing trials (SBT)
Neuromechanical Efficiency (NME)
NME is the ratio between inspiratory pressure generation and EAdi (Paw/EAdi).
Time frame: at 30 minutes of the spontaneous breathing trials (SBT)
In a 20 beds general ICU of a teaching hospital, from December 2008 to May 2010, 52 patients , mechanically ventilated for \> 24 h, were included when they deemed ready for extubation by the clinical team and fulfilled established weaning criteria.
| Milestone | Weaning Failure | Weaning Successful |
|---|---|---|
| Started | 17 | 35 |
| Completed | 17 | 35 |
| Not completed | 0 | 0 |
NVE is the ratio of tidal volume and diaphragm electrical activity (Vt/EAdi).It is a value describing how effective a patient's breathing is.
| ml/uV | Weaning Failure | Weaning Successful |
|---|---|---|
| Neuroventilatory Efficiency (NVE) | 17.6 ± 10.7 | 39.9 ± 23.9 |
NME is the ratio between inspiratory pressure generation and EAdi (Paw/EAdi).
| cmH2O/uV | Weaning Failure | Weaning Successful |
|---|---|---|
| Neuromechanical Efficiency (NME) | 1.13 ± 0.71 | 1.77 ± 0.79 |
Collected over During the 30 nints of SBT, and 48 hours after extubation. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Weaning Failure | — | 0/17 (0%) | 0/17 (0%) |
| Weaning Successful | — | 0/35 (0%) | 0/35 (0%) |
| Age, Categorical(Participants) | Weaning Failure | Weaning Successful | Total |
|---|---|---|---|
| <=18 years | 0 | 0 | 0 |
| Between 18 and 65 years | 1 | 13 | 14 |
| >=65 years | 16 | 22 | 38 |
| Age Continuous(years) | Weaning Failure | Weaning Successful | Total |
|---|---|---|---|
| Mean | 76.0 ± 6.4 | 65.2 ± 18.5 | 68.8 ± 16.4 |
| Sex: Female, Male(Participants) | Weaning Failure | Weaning Successful | Total |
|---|---|---|---|
| Female | 9 | 11 | 20 |
| Male | 8 | 24 | 32 |
| Region of Enrollment(participants) | Weaning Failure | Weaning Successful | Total |
|---|---|---|---|
| China | 17 | 35 | 52 |
This study is completed, as verified in Aug 2011. You cannot join it, but the record below documents what was studied.
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Southeast University, China