Hypercapnic Ventilatory Response in the Weaning of Patients with Prolonged Mechanical Ventilation
Objective. To investigate whether hypercapnic ventilatory response (defined as the ratio of the change in minute ventilation [ΔV˙E] to the change in end-tidal partial pressure of carbon dioxide [ΔPETCO2]) is a predictor of successful weaning in patients with prolonged mechanical ventilation (PMV) an...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-01-01
|
| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2017/7381424 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832550441689284608 |
|---|---|
| author | Chung-Shu Lee Ning-Hung Chen Li-Pang Chuang Chih-Hao Chang Li-Fu Li Shih-Wei Lin Hsiung-Ying Huang |
| author_facet | Chung-Shu Lee Ning-Hung Chen Li-Pang Chuang Chih-Hao Chang Li-Fu Li Shih-Wei Lin Hsiung-Ying Huang |
| author_sort | Chung-Shu Lee |
| collection | DOAJ |
| description | Objective. To investigate whether hypercapnic ventilatory response (defined as the ratio of the change in minute ventilation [ΔV˙E] to the change in end-tidal partial pressure of carbon dioxide [ΔPETCO2]) is a predictor of successful weaning in patients with prolonged mechanical ventilation (PMV) and to determine a reference value for clinical use. Methods. A hypercapnic challenge test was performed on 32 PMV subjects (average age: 74.3 years ± 14.9 years). The subjects were divided into two groups (i.e., weaning successes and weaning failures) and their hypercapnic ventilatory responses were compared. Results. PMV subjects had an overall weaning rate of 68.8%. The weaning-success and weaning-failure groups had hypercapnic ventilatory responses (ΔV˙E/ΔPETCO2) of 0.40±0.16 and 0.28±0.12 L/min/mmHg, respectively (P=.036). The area under the receiver operating characteristic curve was 0.716 of the hypercapnic ventilatory response, and the practical hypercapnic ventilatory response cut-off point for successful weaning was 0.265 with 86.4% sensitivity and 50% specificity. Conclusions. PMV subjects who failed weaning had a lower hypercapnic ventilatory response than successfully weaned subjects. However, the prediction capacity of this test, assessed by the area under the receiver operating characteristic (ROC) curve, poorly predicted weaning outcome. |
| format | Article |
| id | doaj-art-b06009593fa4427c85768dea63a0f224 |
| institution | Kabale University |
| issn | 1198-2241 1916-7245 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-b06009593fa4427c85768dea63a0f2242025-02-03T06:06:50ZengWileyCanadian Respiratory Journal1198-22411916-72452017-01-01201710.1155/2017/73814247381424Hypercapnic Ventilatory Response in the Weaning of Patients with Prolonged Mechanical VentilationChung-Shu Lee0Ning-Hung Chen1Li-Pang Chuang2Chih-Hao Chang3Li-Fu Li4Shih-Wei Lin5Hsiung-Ying Huang6Department of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Hsing St., Kueishan Dist., Taoyuan City, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Hsing St., Kueishan Dist., Taoyuan City, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Hsing St., Kueishan Dist., Taoyuan City, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Hsing St., Kueishan Dist., Taoyuan City, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Hsing St., Kueishan Dist., Taoyuan City, TaiwanDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Linkou, No. 5, Fu-Hsing St., Kueishan Dist., Taoyuan City, TaiwanDepartment of Pulmonary and Critical Care Medicine, Xiamen Chang Gung Hospital, Xiamen City, ChinaObjective. To investigate whether hypercapnic ventilatory response (defined as the ratio of the change in minute ventilation [ΔV˙E] to the change in end-tidal partial pressure of carbon dioxide [ΔPETCO2]) is a predictor of successful weaning in patients with prolonged mechanical ventilation (PMV) and to determine a reference value for clinical use. Methods. A hypercapnic challenge test was performed on 32 PMV subjects (average age: 74.3 years ± 14.9 years). The subjects were divided into two groups (i.e., weaning successes and weaning failures) and their hypercapnic ventilatory responses were compared. Results. PMV subjects had an overall weaning rate of 68.8%. The weaning-success and weaning-failure groups had hypercapnic ventilatory responses (ΔV˙E/ΔPETCO2) of 0.40±0.16 and 0.28±0.12 L/min/mmHg, respectively (P=.036). The area under the receiver operating characteristic curve was 0.716 of the hypercapnic ventilatory response, and the practical hypercapnic ventilatory response cut-off point for successful weaning was 0.265 with 86.4% sensitivity and 50% specificity. Conclusions. PMV subjects who failed weaning had a lower hypercapnic ventilatory response than successfully weaned subjects. However, the prediction capacity of this test, assessed by the area under the receiver operating characteristic (ROC) curve, poorly predicted weaning outcome.http://dx.doi.org/10.1155/2017/7381424 |
| spellingShingle | Chung-Shu Lee Ning-Hung Chen Li-Pang Chuang Chih-Hao Chang Li-Fu Li Shih-Wei Lin Hsiung-Ying Huang Hypercapnic Ventilatory Response in the Weaning of Patients with Prolonged Mechanical Ventilation Canadian Respiratory Journal |
| title | Hypercapnic Ventilatory Response in the Weaning of Patients with Prolonged Mechanical Ventilation |
| title_full | Hypercapnic Ventilatory Response in the Weaning of Patients with Prolonged Mechanical Ventilation |
| title_fullStr | Hypercapnic Ventilatory Response in the Weaning of Patients with Prolonged Mechanical Ventilation |
| title_full_unstemmed | Hypercapnic Ventilatory Response in the Weaning of Patients with Prolonged Mechanical Ventilation |
| title_short | Hypercapnic Ventilatory Response in the Weaning of Patients with Prolonged Mechanical Ventilation |
| title_sort | hypercapnic ventilatory response in the weaning of patients with prolonged mechanical ventilation |
| url | http://dx.doi.org/10.1155/2017/7381424 |
| work_keys_str_mv | AT chungshulee hypercapnicventilatoryresponseintheweaningofpatientswithprolongedmechanicalventilation AT ninghungchen hypercapnicventilatoryresponseintheweaningofpatientswithprolongedmechanicalventilation AT lipangchuang hypercapnicventilatoryresponseintheweaningofpatientswithprolongedmechanicalventilation AT chihhaochang hypercapnicventilatoryresponseintheweaningofpatientswithprolongedmechanicalventilation AT lifuli hypercapnicventilatoryresponseintheweaningofpatientswithprolongedmechanicalventilation AT shihweilin hypercapnicventilatoryresponseintheweaningofpatientswithprolongedmechanicalventilation AT hsiungyinghuang hypercapnicventilatoryresponseintheweaningofpatientswithprolongedmechanicalventilation |