Comparisons of predictive performance of breathing pattern variability measured during T-piece, automatic tube compensation, and pressure support ventilation for weaning intensive care unit patients from mechanical ventilation

Critical Care Medicine

Volumn 39, Issue 10, 2011, Pages 2253-2262

  Bien, Mauo Ying ^a   Shui Lin, You ^b   Shih, Chung Hung ^a   Yang, You Lan ^a   Lin, Hui Wen ^a   Bai, Kuan Jen ^a,c   Wang, Jia Horng ^a,d   Kou, Yu Ru ^e  

^a TAIPEI MEDICAL UNIVERSITY HOSPITAL   (Taiwan)

^b Department of Physiology ^*  (Taiwan)

^c TAIPEI MEDICAL UNIVERSITY   (Taiwan)

^d TAIPEI VETERANS GENERAL HOSPITAL   (Taiwan)

^e NATIONAL YANG MING UNIVERSITY   (Taiwan)

Author keywords

breathing pattern variability; classification and regression tree analysis; receiver operating characteristic curve; spontaneous breathing trial; weaning predictor

Indexed keywords

ADULT; AGED; ARTICLE; ARTIFICIAL VENTILATION; ASSISTED VENTILATION; BREATHING; BREATHING PATTERN; EXTUBATION; FEMALE; HUMAN; INSPIRATORY AUTOMATIC TUBE COMPENSATION; INTENSIVE CARE UNIT; MAJOR CLINICAL STUDY; MALE; PEAK INSPIRATORY FLOW; POSITIVE END EXPIRATORY PRESSURE; PREDICTIVE VALUE; PRESSURE SUPPORT VENTILATION; PRIORITY JOURNAL; SHALLOW BREATHING INDEX; TIDAL VOLUME; TREATMENT FAILURE;

EID: 80052969792     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0b013e31822279ed     Document Type: Article

References (48)

1. 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 (Pubitemid 34015780)
2. MacIntyre N: Discontinuing mechanical ventilatory support. Chest 2007; 132:1049-1056
3. Boles JM, Bion J, Connors A, et al: Weaning from mechanical ventilation. Eur Respir J 2007; 29:1033-1056 (Pubitemid 46722227)
4. Meade M, Guyatt G, Cook D, et al: Predicting success in weaning from mechanical ventilation. Chest 2001; 120:400S-424S (Pubitemid 34015782)
5. Yang KL, Tobin MJ: A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med 1991; 324:1445-1450
6. Chatila W, Jacob B, Guaglionone D, et al: The unassisted respiratory rate-tidal volume ratio accurately predicts weaning outcome. Am J Med 1996; 101:61-67 (Pubitemid 26285942)
7. Jacob B, Chatila W, Manthous CA: The unassisted respiratory rate/tidal volume ratio accurately predicts weaning outcome in postoperative patients. Crit Care Med 1997; 25: 253-257 (Pubitemid 27086059)
8. Khan N, Brown A, Venkataraman ST: Predictors of extubation success and failure in mechanically ventilated infants and children. Crit Care Med 1996; 24:1568-1579 (Pubitemid 26313762)
9. Krieger BP, Isber J, Breitenbucher A, et al: Serial measurements of the rapid-shallowbreathing index as a predictor of weaning outcome in elderly medical patients. Chest 1997; 112:1029-1034 (Pubitemid 27446325)
10. Tanios MA, Nevins ML, Hendra KP, et al: A randomized, controlled trial of the role of weaning predictors in clinical decision making. Crit Care Med 2006; 34:2530-2535 (Pubitemid 44413048)
11. Vallverdú I, Calaf N, Subirana M, et al: Clinical characteristics, respiratory functional parameters, and outcome of a two-hour Tpiece trial in patients weaning from mechanical ventilation. Am J Respir Crit Care Med 1998; 158:1855-1862 (Pubitemid 29008825)
12. Bien MY, Lin YS, Shie HG, et al: Rapid shallow breathing index and its predictive accuracy measured under five different ventilatory strategies in the same patient group. Chinese J Physiol 2010; 53:1-10
13. Patel KN, Ganatra KD, Bates JH, et al: Variation in the rapid shallow breathing index associated with common measurement techniques and conditions. Respir Care 2009; 54: 1462-1466
14. Engoren M: Approximate entropy of respiratory rate and tidal volume during weaning from mechanical ventilation. Crit Care Med 1998; 26:1817-1823 (Pubitemid 28527692)
15. Benchetrit G: Breathing pattern in humans: Diversity and individuality. Respir Physiol 2000; 122:123-129 (Pubitemid 30628335)
16. Brack T, Jubran A, Tobin MJ: Dyspnea and decreased variability of breathing in patients with restrictive lung disease. Am J Respir Crit Care Med 2002; 165:1260-1264 (Pubitemid 34461736)
17. Loveridge B, West P, Anthonisen NR, et al: Breathing patterns in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis 1984; 130:730-733 (Pubitemid 15209550)
18. Schechtman VL, Lee MY, Wilson AJ, et al: Dynamics of respiratory patterning in normal infants and infants who subsequently died of the sudden infant death syndrome. Pediatr Res 1996; 40:571-577 (Pubitemid 26332584)
19. Bien MY, Yien HW, Hseu SS, et al: Instability of spontaneous breathing patterns in patients with persistent vegetative state. Respir Physiol Neurobiol 2005; 145:163-175
20. El-Khatib M, Jamaleddine G, Soubra R, et al: Pattern of spontaneous breathing: Potential marker for weaning outcome. Spontaneous breathing pattern and weaning from mechanical ventilation. Intensive Care Med 2001; 27:52-58 (Pubitemid 32208969)
21. Bien MY, Hseu SS, Yien HW, et al: Breathing pattern variability: A weaning predictor in postoperative patients recovering from systemic inflammatory response syndrome. Intensive Care Med 2004; 30:241-247
22. Wysocki M, Cracco C, Teixeira A, et al: Reduced breathing variability as a predictor of unsuccessful patient separation from mechanical ventilation. Crit Care Med 2006; 34: 2076-2083 (Pubitemid 44305608)
23. Casaseca-de-la-Higuera P, Martín-Fernández M, Alberola-López C: Weaning from mechanical ventilation: A retrospective analysis leading to a multimodal perspective. IEEE Trans Biomed Eng 2006; 53:1330-1345 (Pubitemid 44172307)
24. Casaseca-de-la-Higuera P, Simmross-Wattenberg F, Martín- Fernández M, et al: A multichannel model-based methodology for extubation readiness decision of patients on weaning trials. IEEE Trans Biomed Eng 2009; 56:1849-1863
25. Wysocki M, Cracco C, Teixerira A, et al: Breathing variability: Perspectives for the critically ill patient. Réanimation 2006; 15: 7-13 (Pubitemid 43213029)
26. Papaioannou V, Dragoumanis C, Pneumatikos I: Biosignal analysis techniques for weaning outcome assessment. J Crit Care 2010; 25:39-46
27. Kuhlen R, Max M, Dembinski R, et al: Breathing pattern and workload during automatic tube compensation, pressure support and T-piece trials in weaning patients. Eur J Anaesthesiol 2003; 20:10-16 (Pubitemid 36077095)
28. Fabry B, Haberthü r C, Zappe D: Breathing pattern and additional work of breathing in spontaneously breathing patients with different ventilatory demands during inspiratory pressure support and automatic tube compensation. Intensive Care Med 1997; 23:545-552 (Pubitemid 27263067)
29. Cohen JD, Shapiro M, Grozovski E, et al: Extubation outcome following a spontaneous breathing trial with automatic tube compensation versus continuous positive airway pressure. Crit Care Med 2006; 34:682-686
30. Haberthü r C, Mols G, Elsasser S, et al: Extubation after breathing trials with automatic tube compensation, T-tube, or pressure support ventilation. Acta Anaesthesiol Scand 2002; 46:973-979
31. Cohen J, Shapiro M, Grozovski E, et al: Prediction of extubation outcome: A randomised, controlled trial with automatic tube compensation vs. pressure support ventilation. Crit Care 2009; 13:R21
32. Taniguchi C, Eid RC, Saghabi C, et al: Automatic versus manual pressure support reduction in the weaning of post-operative patients: A randomised controlled trial. Crit Care 2009; 13:R6
33. Vitacca M, Ambrosino N, Clini E, et al: Physiological response to pressure support ventilation delivered before and after extubation in patients not capable of totally spontaneous autonomous breathing. Am J Respir Crit Care Med 2001; 164:638-641 (Pubitemid 32801669)
34. Mangin L, Fiamma MN, Straus C, et al: Source of human ventilatory chaos: Lessons from switching controlled mechanical ventilation to inspiratory pressure support in critically ill patients. Respir Physiol Neurobiol 2008; 161:189-196 (Pubitemid 351551593)
35. Fiamma MN, Straus C, Thibault S, et al: Effects of hypercapnia and hypocapnia on ventilatory variability and the chaotic dynamics of ventilatory flow in humans. Am J Physiol Regul Integr Comp Physiol 2007; 292:R1985-R1993 (Pubitemid 46708556)
36. Liu Y, Wei LQ, Li GQ, et al: A decision-tree model for predicting extubation outcome in elderly patients after a successful spontaneous breathing trial. Anesth Analg 2010; 111: 1211-1218
37. Yang KL, Tobin MJ: Measurement of minute ventilation in ventilator-dependent patients: Need for standardization. Crit Care Med 1991; 19:49-53
38. Marini JJ, Smith TC, Lamb V: Estimation of inspiratory muscle strength in mechanically ventilated patients: The measurement of maximal inspiratory pressure. Crit Care 1986; 1:32-38 (Pubitemid 17107503)
39. DeLong ER, DeLong DM, Clarke-Pearson DL: Comparing the areas under two or more correlated receiver operating characteristic curves: A nonparametric approach. Biometrics 1988; 44:837-845
40. Bruce EN, Daubenspeck JA: Mechanisms and analysis of ventilatory stability. In: Regula tion of Breathing. Dempsey JA, Pack AI (Eds). New York, Marcel Dekker, 1995, pp 285-313
41. Bruce EN: Chemoreflex and vagal afferent mechanisms enhance breath to breath variability of breathing. Respir Physiol 1997; 110:237-244 (Pubitemid 27505190)
42. Bersten AD, Rutten AJ, Vedig AE, et al: Additional work of breathing imposed by endotracheal tubes, breathing circuits, and intensive care ventilators. Crit Care Med 1989; 17:671-677 (Pubitemid 19200316)
43. Brack T, Jubran A, Tobin MJ: Effect of resistive loading on variational activity of breathing. Am J Respir Crit Care Med 1998; 157: 1756-1763
44. Goldman LJ, Jarabo RM, Gómez RG: Airway pressure alters wavelet fractal dynamics and short-range dependence of respiratory variability. Respir Physiol Neurobiol 2008; 161: 29-40 (Pubitemid 351324210)
45. Johannigman JA, Davis K Jr, Campbell RS, et al: Use of the rapid/shallow breathing index as an indicator of patient work of breathing during pressure support ventilation. Surgery 1997; 122:737-741 (Pubitemid 27452584)
46. Mols G, Guttmann J: "Simplify your life" does not necessarily work when applying automatic tube compensation and proportional assist ventilation. Crit Care Med 2005; 33: 2125-2126 (Pubitemid 41306545)
47. Ezingeard E, Diconne E, Guyomarc'h S, et al: Weaning from mechanical ventilation with pressure support in patients failing a T-tube trial of spontaneous breathing. Intensive Care Med 2006; 32:165-169 (Pubitemid 43039393)
48. Hamilton Medical: Hamilton.G5 Operational Manual 624074/02, Software Version 1.1x, F2008; pp. 7-6, 7-7, A-18, A-28