Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-19843
Haberthür, C; Mols, G; Elsasser, S; Bingisser, R; Stocker, R; Guttmann, J (2002). Extubation after breathing trials with automatic tube compensation, T-tube, or pressure support ventilation. Acta Anaesthesiologica Scandinavica, 46(8):973-979.
- Registered users only
View at publisher
BACKGROUND: Automatic tube compensation (ATC) is a new option to compensate for the pressure drop across the endotracheal or tracheostomy tube (ETT), especially during ventilator-assisted spontaneous breathing. While several benefits of this mode have so far been documented, ATC has not yet been used to predict whether the ETT could be safely removed at the end of weaning, from mechanical ventilation. METHODS: We undertook a systematic trial using a randomized block design. During a 2-year period, all eligible patients of a medical intensive care unit were treated with ATC, conventional pressure support ventilation (PSV, 5 cmH2O), or T-tube for 2-h. Tolerance of the breathing trial served as a basis for the decision to remove the endotracheal tube. Extubation failure was considered if reintubation was necessary or if the patient required non-invasive ventilatory assistance (both within 48 h). RESULTS AND CONCLUSIONS: After the inclusion of 90 patients (30 per group) we did not observe significant differences between the modes. Twelve patients failed the initial weaning trial. However, half of the patients who appeared to fail the spontaneous breathing trial on the T-tube, PSV, or both, were successfully extubated after a succeeding trial with ATC. Extubation was thus withheld from four and three of these patients while breathing with PSV or the T-tube, respectively, but to any patient breathing with ATC. It seems that ATC can be used as an alternative mode during the final phase of weaning from mechanical ventilation. Furthermore, this study may promote a larger multicenter trial on weaning with ATC compared with standard modes.
1 download since deposited on 16 Sep 2009
0 downloads since 12 months
|Item Type:||Journal Article, refereed, original work|
|Communities & Collections:||04 Faculty of Medicine > University Hospital Zurich > Division of Surgical Intensive Care Medicine|
|DDC:||610 Medicine & health|
|Deposited On:||16 Sep 2009 06:53|
|Last Modified:||27 Nov 2013 19:14|
|Additional Information:||The definitive version is available at www.blackwell-synergy.com|
Users (please log in): suggest update or correction for this item
Repository Staff Only: item control page