Effects of Different Spontaneous Breathing Trials on Respiratory Mechanics Parameters of COPD Patients_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

DuanJunfeng ,  ChenXiaoju , WangTao , ZhangWenbo , XiangXiaojun

Department of Respiratory Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, 637000, China;

Corresponding?author：

ChenXiaoju, Email: cxj9592@163.com

Keywords：

Chronic obstructive pulmonary diaease; Mechanical ventilation; Weaning; Spontaneous breathing trials; Automatic tube compensation

DOI：

10.7507/1671-6205.2014003

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To compare the difference of respiratory mechanics parameters between three different spontaneous breathing trials on COPD patients in weaning process. Methods 17 patients with COPD underwent mechanical ventilation for at least 48 hours who were stable and ready for weaning were enrolled. All patients underwent three spontaneous breathing trials, ie, automatic tube compensation (ATC,compensation level 100%),low level pressure support ventilation (PSV,7 cm H₂O) and T-piece. Each spontaneous breathing trials continued for 10 minutes. Before each autonomous respiration experiment ended,the respiratory mechanics parameters including high airway pressure (PIP),breathing rate (RR),blood oxygen saturation (SaO₂),airway occlusion pressure at 0.1 second (P0.1),maximal inspiratory mouth pressure(Pimax) and rapid shallow breathing index (RSBI) were measured. Their differences between three spontaneous breathing trials were compared. Results 12 patients successfully completed three different methods of spontaneous breathing test. Compared with the T-piece,P0.1,Pimax,RSBI and RR in the COPD patients using low level PSV and ATC were significantly decreased while V_T and SaO₂ were increased. The difference of each parameter in the low level PSV group and the ATC group had statistical significance compared with T-piece group (P<0.05). Compared with the low PSV group,P0.1,Pimax,RSBI and RR in ATC group were elevated while PIP,V_T and SaO₂ were reduced. The differences of P0.1,Pimax,RSBI,PIP and RR between two groups were statistically significant (P<0.05). Conclusion For COPD patients in weaning process with spontaneous breathing trial,both low levels of PSV and ATC are better than T-piece,and the patients are more comfortable with ATC100% than PSV.

Citation： DuanJunfeng, ChenXiaoju, WangTao, ZhangWenbo, XiangXiaojun. Effects of Different Spontaneous Breathing Trials on Respiratory Mechanics Parameters of COPD Patients. Chinese Journal of Respiratory and Critical Care Medicine, 2014, 13(1): 10-13. doi: 10.7507/1671-6205.2014003 Copy

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11.	Cohen JD,Shapiro M,Grozovski E,et al.Automatic tube compensation-assisted respiratory rate to tidal volume ratio improves the prediction of weaning outcome.Chest,2002,122:980-984.
12.	Figueroa-Casas JB,Montoya R,Arzabala A,et al.Comparison between automatic tube compensation and continuous positive airway pressure during spontaneous breathing trials.Respir Care,2010,55:549-554.
13.	羅彬,朱曉瓊.淺快呼吸指數對慢性阻塞性肺疾病患者撤機的意義.吉林醫學,2009,30:2255-2256.
14.	馬玉杰,曹相原.淺快呼吸指數的變化趨勢在機械通氣撤離中的預測價值.中國呼吸與危重監護雜志,2010,9:567-569.

1. Boutou AK,Abatzidou F,Tryfon S,et al.Diagnostic accuracy of the rapid shallow breathing index to predict a successful spontaneous breathing trial outcome in mechanically ventilated patients with chronic obstructive pulmonary disease.Heart Lung,2011,40:105-110.
2. 中華醫學會呼吸病學分會慢性阻塞性肺疾病學組.慢性阻塞性肺疾病診治指南(2007年修訂版).中華內科雜志,2007,46:254-261.
3. MacIntyre NR,Cook DJ,Ely EW Jr,et al.Evidence-based guidelines for weaning and discontinuing ventilatory support:a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine.Chest,2001,120:375S-395S.
4. 陳宇清,陳欽,周新.自動導管阻力補償技術聯合壓力支持通氣對撤機患者呼吸力學參數的影響.生物醫學工程與臨床,2009,13:328-331.
5. Frutos-Vivar F, Esteban A.When to wean from a ventilator:an evidence-based strategy.Cleve Clin J Med,2003,70:389-340.
6. Guttmann J,Haberthür C,Mols G.Automatic tube compensation.Respir Care Clin N Am,2001,7:475-501.
7. 俞森洋,羅顯榮.呼吸危重病學.北京:中國協和醫科大學出版社,2008,470-473.
8. Tanios MA,Epstein SK.Spontaneous breathing trials:should we use automatic tube compensation.Respir Care,2010,55:640-642.
9. 鄧琳,龔鴻昌.機械通氣患者的不同撤機方式的研究.四川醫學,2011,32:1417-1418.
10. Unoki T,Serita A,Grap MJ.Automatic tube compensation during weaning from mechanical ventilation:evidence and clinical implications.Crit Care Nurse,2008,28:34-42.
11. Cohen JD,Shapiro M,Grozovski E,et al.Automatic tube compensation-assisted respiratory rate to tidal volume ratio improves the prediction of weaning outcome.Chest,2002,122:980-984.
12. Figueroa-Casas JB,Montoya R,Arzabala A,et al.Comparison between automatic tube compensation and continuous positive airway pressure during spontaneous breathing trials.Respir Care,2010,55:549-554.
13. 羅彬,朱曉瓊.淺快呼吸指數對慢性阻塞性肺疾病患者撤機的意義.吉林醫學,2009,30:2255-2256.
14. 馬玉杰,曹相原.淺快呼吸指數的變化趨勢在機械通氣撤離中的預測價值.中國呼吸與危重監護雜志,2010,9:567-569.

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