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Comparison of Energy Expenditure and Oxygen Consumption of Spontaneous Breathing Trial Conducted With and Without Automatic Tube Compensation.

Lago AF, Goncalves EC, Silva EC, Menegueti MG, Nicolini EA, Auxiliadora-Martins M, Martinez EZ, Gastaldi AC, Basile-Filho A - J Clin Med Res (2015)

Bottom Line: Forty mechanically ventilated patients were admitted to an intensive care unit of a university tertiary hospital.The differences between VO2 and EE obtained during SBT with ATC and without ATC were -1.6 mL/kg/min (95% CI: -4.36 - 1.07) and 5.4 kcal/day (95% CI: -21.67 - 10.79), respectively.We concluded that VO2 and EE obtained during SBT with and without ATC were not different.

View Article: PubMed Central - PubMed

Affiliation: Division of Intensive Care, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, SP 14049-900 Ribeirao Preto, Brazil.

ABSTRACT

Background: Weaning from mechanical ventilation is defined as the process of release of ventilatory support and how the evaluation of this phase is conducted in the spontaneous breathing trial (SBT). One of the most used modes of SBT is the continuous positive airway pressure (CPAP), which applies a continuous positive pressure in both inspiration and expiration. However, together with the mechanical ventilation modes, the automatic tube compensation (ATC) can be used, which compensates the resistance imposed by the endotracheal tube. The objective of this study was to compare oxygen consumption (VO2) and energy expenditure (EE) during SBT conducted with and without ATC.

Methods: The study was prospective, randomized and crossover. Forty mechanically ventilated patients were admitted to an intensive care unit of a university tertiary hospital. The participants were randomly allocated in group 1, in which SBT was initiated with CPAP and ATC, followed by CPAP without ATC or in group 2, in which SBT was initiated with CPAP without ATC, followed by CPAP with ATC. Indirect calorimetry helped to measure VO2 and EE during SBT.

Results: The differences between VO2 and EE obtained during SBT with ATC and without ATC were -1.6 mL/kg/min (95% CI: -4.36 - 1.07) and 5.4 kcal/day (95% CI: -21.67 - 10.79), respectively.

Conclusions: We concluded that VO2 and EE obtained during SBT with and without ATC were not different.

No MeSH data available.


Box plot of VO2, EE, VCO2, and RQ at baseline, with and without ATC. The diamonds are atypical values (outliers).
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Figure 2: Box plot of VO2, EE, VCO2, and RQ at baseline, with and without ATC. The diamonds are atypical values (outliers).

Mentions: Eighteen (51%) of the participants were male. The mean age, the mean APACHE II score, and the mean SAPS 3 score were 61 years (SD 16), 24 (SD 8.4), and 67 (SD 22), respectively. Six patients (15%) died. The mean length of ICU and hospital stay was 14 days (SD 8) and 78 days (SD 71), respectively. Table 1 lists the clinical data; Figure 2 illustrates VO2, EE, VCO2, and RQ throughout the study. The difference between the averages of the values related during the SBT with and without ATC, group 1 and group 2, and period 1 pre-washout and period 2 after washout are demonstrated in Table 2.


Comparison of Energy Expenditure and Oxygen Consumption of Spontaneous Breathing Trial Conducted With and Without Automatic Tube Compensation.

Lago AF, Goncalves EC, Silva EC, Menegueti MG, Nicolini EA, Auxiliadora-Martins M, Martinez EZ, Gastaldi AC, Basile-Filho A - J Clin Med Res (2015)

Box plot of VO2, EE, VCO2, and RQ at baseline, with and without ATC. The diamonds are atypical values (outliers).
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4522988&req=5

Figure 2: Box plot of VO2, EE, VCO2, and RQ at baseline, with and without ATC. The diamonds are atypical values (outliers).
Mentions: Eighteen (51%) of the participants were male. The mean age, the mean APACHE II score, and the mean SAPS 3 score were 61 years (SD 16), 24 (SD 8.4), and 67 (SD 22), respectively. Six patients (15%) died. The mean length of ICU and hospital stay was 14 days (SD 8) and 78 days (SD 71), respectively. Table 1 lists the clinical data; Figure 2 illustrates VO2, EE, VCO2, and RQ throughout the study. The difference between the averages of the values related during the SBT with and without ATC, group 1 and group 2, and period 1 pre-washout and period 2 after washout are demonstrated in Table 2.

Bottom Line: Forty mechanically ventilated patients were admitted to an intensive care unit of a university tertiary hospital.The differences between VO2 and EE obtained during SBT with ATC and without ATC were -1.6 mL/kg/min (95% CI: -4.36 - 1.07) and 5.4 kcal/day (95% CI: -21.67 - 10.79), respectively.We concluded that VO2 and EE obtained during SBT with and without ATC were not different.

View Article: PubMed Central - PubMed

Affiliation: Division of Intensive Care, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, SP 14049-900 Ribeirao Preto, Brazil.

ABSTRACT

Background: Weaning from mechanical ventilation is defined as the process of release of ventilatory support and how the evaluation of this phase is conducted in the spontaneous breathing trial (SBT). One of the most used modes of SBT is the continuous positive airway pressure (CPAP), which applies a continuous positive pressure in both inspiration and expiration. However, together with the mechanical ventilation modes, the automatic tube compensation (ATC) can be used, which compensates the resistance imposed by the endotracheal tube. The objective of this study was to compare oxygen consumption (VO2) and energy expenditure (EE) during SBT conducted with and without ATC.

Methods: The study was prospective, randomized and crossover. Forty mechanically ventilated patients were admitted to an intensive care unit of a university tertiary hospital. The participants were randomly allocated in group 1, in which SBT was initiated with CPAP and ATC, followed by CPAP without ATC or in group 2, in which SBT was initiated with CPAP without ATC, followed by CPAP with ATC. Indirect calorimetry helped to measure VO2 and EE during SBT.

Results: The differences between VO2 and EE obtained during SBT with ATC and without ATC were -1.6 mL/kg/min (95% CI: -4.36 - 1.07) and 5.4 kcal/day (95% CI: -21.67 - 10.79), respectively.

Conclusions: We concluded that VO2 and EE obtained during SBT with and without ATC were not different.

No MeSH data available.