Introduction: Spontaneous breathing with a conventional T-piece (TT) connected to the tracheal tube orotraqueal has been frequently used in clinical setting to weaning of mechanical ventilation (MV), when compared with pressure support ventilation (PSV). However, the acute effects of spontaneous breathing with TT versus PSV on autonomic function assessed through heart rate variability (HRV) have not been fully elucidated.
Objective: The purpose of this study was to examine the acute effects of spontaneous breathing in TT vs PSV in critically ill patients.
Method: Twenty-one patients who had received MV for ≥ 48 h and who met the study inclusion criteria for weaning were assessed. Eligible patients were randomized to TT and PSV. Cardiorespiratory responses (respiratory rate -ƒ, tidal volume-V , mean blood pressure (MBP) and diastolic blood pressure (DBP), end tidal dioxide carbone (P CO ), peripheral oxygen saturation (SpO ) and HRV indices in frequency domain (low-LF, high frequency (HF) and LF/HF ratio were evaluated.
Results: TT increased ƒ (20 ± 5 vs 25 ± 4 breaths/min, P<0.05), MBP (90 ± 14 vs 94 ± 18 mmHg, P<0.05), HR (90 ± 17 vs 96 ± 12 beats/min, P<0.05), P CO (33 ± 8 vs 48 ± 10 mmHg, P<0.05) and reduced SpO (98 ± 1.6 vs 96 ± 1.6%, P<0.05). In addition, LF increased (47 ± 18 vs 38 ± 12 nu, P<0.05) and HF reduced (29 ± 13 vs 32 ± 16 nu, P<0.05), resulting in higher LF/HF ratio (1.62 ± 2 vs 1.18 ± 1, P<0.05) during TT. Conversely, V increased with PSV (0.58 ± 0.16 vs 0.50 ± 0.15 L, P<0.05) compared with TT.
Conclusion: Acute effects of TT mode may be closely linked to cardiorespiratory mismatches and cardiac autonomic imbalance in critically ill patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/crj.12363 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Mechanical power density, spontaneous breathing indexes, and weaning readiness following prolonged mechanical ventilation.
Respir Med
January 2025
Department of Pulmonology and Respiratory Medicine, Lung Center Stuttgart - Schillerhoehe Lung Clinic, affiliated to the Robert-Bosch-Hospital GmbH, Auerbachstrasse 110, 70376 Stuttgart, Germany; Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), Munich.
Introduction: Evidence suggests that mechanical power (MP) normalized to dynamic compliance, which equals power density, may help identify prolonged ventilated patients at risk for spontaneous breathing trial (SBT) failure. This study compared MP density with traditional spontaneous breathing indexes to predict a patient's capacity to sustain a short trial of unassisted breathing.
Methods: A prospective observational study on 186 prolonged ventilated, tracheotomized patients.
Background: A multi-center study in Los Angeles (USC), Kansas City (KUMC) and Dallas (UT-SWMC) quantified via predictive modeling the dynamics of cerebral perfusion regulation (CO2 vasoreactivity and cerebral autoregulation) in MCI/AD patients and cognitively normal controls under resting conditions. The goal was to develop model-based physio-markers for accurate diagnosis of MCI and pre-clinical AD, motivated by our previous findings of significant impairment of cerebral perfusion regulation in MCI and mild AD patients.
Method: Continuous spontaneous changes in arterial blood pressure, end-tidal CO2, cerebral blood flow velocity in middle cerebral arteries and cortical tissue oxygenation at lateral prefrontal cortex were recorded over two 6-8 min sessions, separated by session of slow-paced breathing (6 breaths/minute), in 53 MCI (28 APOE4 non-carriers and 25 APOE4 carriers), 33 mild AD patients (13 APOE4 non-carriers and 20 APOE4 carriers) and 74 age/sex-matched cognitively normal controls (50 APOE4 non-carriers and 24 APOE4 carriers).
The effects of paced breathing on psychological distress vulnerability and heart rate variability in adults sustaining traumatic injury.
J Affect Disord
January 2025
Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; John Walsh Centre Rehabilitation Research, Northern Sydney Local Health District, St Leonards, Sydney, NSW, Australia.
Background: Traumatic physical injuries can lead to psychological distress and increased risk of psychiatric disorders, often reflected in dysregulated autonomic responses measurable through heart rate variability (HRV). Slow-paced breathing has shown potential in enhancing HRV, but its effectiveness in injured survivors remains unexplored. This study investigates the effect of slow-paced breathing on HRV among injured survivors compared to non-injured individuals and explores the influence of psychological distress and spontaneous respiratory rate on this effect.
View Article and Find Full Text PDFGlanzmann Thrombasthenia in a Newborn Due to a Rare Homozygous Missense Mutation.
Cureus
December 2024
Obstetrics and Gynecology, Latifa Hospital, Dubai, ARE.
Glanzmann thrombasthenia (GT) is an autosomal recessive platelet functional bleeding disorder caused by mutations in the ITGA2B or ITGB3 genes, often presenting as mucocutaneous bleeding. GT typically presents in infancy, but this study reports a rare case of neonatal presentation in a female infant born to consanguineous parents. The mother, a 27-year-old woman with a family history of GT, presented at 36 weeks gestation for an elective cesarean due to a breech presentation.
View Article and Find Full Text PDFBest clinical model predicting extubation failure: a diagnostic accuracy post hoc analysis.
Intensive Care Med
January 2025
Critical Care Medicine, Complejo Hospitalario Universitario de Toledo, Toledo, Spain.
Purpose: Predicting extubation failure remains a clinical challenge. This study aimed to determine diagnostic accuracy of models used at the bed side.
Methods: Post hoc analysis of 2341 patients at all risk included in five multicenter randomized trials.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!