Abstract:
PURPOSE:Rapid shallow breathing may occur at any time during spontaneous breathing trials (SBT), questioning the utility of a single determination of the rapid shallow breathing index (RSBI). We hypothesize that change in RSBI during SBT may more accurately predict successful extubation than a single determination. METHODS:Prospective observational study. Seventy-two subjects were extubated. At 24 h, 63/72 remained extubated (Extubation Success), and 9 were re-intubated (Extubation Failure). Respiratory rate (RR), tidal volume (VT) and RSBI were measured every 30 min during 2-h T-piece SBT. Change in respiratory parameters was assessed as percent change from baseline. RESULTS:Initial RSBI was similar in Extubation Success and Extubation Failure groups (77.0 +/- 4.8, 77.0 +/- 4.8, p = ns). Nevertheless, RSBI tended to remain unchanged or decreased in the Extubation Success group; in contrast RSBI tended to increase in the Extubation Failure group because of either increased RR and/or decreased VT (p < 0.001 for mean percent change RSBI over time), indicating worsening of the respiratory pattern. Quantitatively, only 7/63 subjects of the Extubation Success group demonstrated increased RSBI >or=20% at any time during the SBT. In contrast, in the Extubation Failure group, RSBI increased in all subjects during the SBT, and eight of nine subjects demonstrated an increase greater than 20%. Thus, with a 2-h SBT the optimal threshold was a 20% increase (sensitivity = 89%, specificity = 89%). Similar results were obtained at 30 min (threshold = 5% increase). Percent change of RSBI predicted successful extubation even when initial values were >or=105. CONCLUSION:Percent change of RSBI during an SBT is a better predictor of successful extubation than a single determination of RSBI.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Segal LN,Oei E,Oppenheimer BW,Goldring RM,Bustami RT,Ruggiero S,Berger KI,Fiel SBdoi
10.1007/s00134-009-1735-6subject
Has Abstractpub_date
2010-03-01 00:00:00pages
487-95issue
3eissn
0342-4642issn
1432-1238journal_volume
36pub_type
杂志文章abstract:PURPOSE:Assessing feasibility and physiological effects of sedation with sevoflurane, administered with the anesthetic conserving device (AnaConDa), in comparison with propofol and remifentanil. METHODS:Seventeen patients undergoing mechanical ventilation underwent sedation with sevoflurane delivered with AnaConDa (ph...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-009-1414-7
更新日期:2009-07-01 00:00:00
abstract:INTRODUCTION:The concept of weaning-induced cardiac dysfunction emerged 26 years ago with the publication of a clinical study conducted by François Lemaire and collaborators. OBJECTIVES:One objective of this article is to remember the results and the historical context under which our pivotal study was conducted. Anot...
journal_title:Intensive care medicine
pub_type: 历史文章,杂志文章,评审
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更新日期:2014-08-01 00:00:00
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abstract:OBJECTIVE:A case-control comparison of Doppler guidance on the success rate of central venous cannulation in patients with normal or reduced intracranial compliance. DESIGN:A single operator performed central venous access procedures with continuous wave Doppler guidance. It was used on patients on a ventilator. The p...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-003-1862-4
更新日期:2003-09-01 00:00:00
abstract:PURPOSE:To determine whether erythromycin is non-inferior to metoclopramide in facilitating post-pyloric placement of self-propelled spiral nasoenteric tubes (NETs) in critically ill patients. METHODS:A prospective, multicenter, open-label, parallel, and non-inferiority randomized controlled trial was conducted compar...
journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2018-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s00134-017-4698-z
更新日期:2017-05-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2007-06-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-014-3226-7
更新日期:2014-04-01 00:00:00
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更新日期:2009-10-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2010-09-01 00:00:00
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更新日期:2011-10-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1727-x
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:Measurement of functional residual capacity (FRC) during controlled and especially during assisted ventilation remains a challenge in the physiological evaluation of ventilated patients. To validate a bag-in-box closed helium dilution technique allowing measurements both during pressure-controlled (PCV) and p...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0833-6
更新日期:2007-12-01 00:00:00
abstract::We examined the incidence, diagnosis and therapy of acute adrenal insufficiency, secondary to adrenal hemorrhage. This insufficiency resulted in temperature irregularities. hemodynamic instability, and a large volume resuscitation requirement post-operatively. The case illustrates that a high level of suspicion should...
journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:1994-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-003-1892-y
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:Hospital mortality of patients with septic multiorgan failure (MOF) is still around 95%. The present study investigates whether this high mortality could be significantly reduced by the addition of sequential hemofiltration (SH) with bicarbonate hemodialysis (HD) to the currently used life supportive measures...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01726531
更新日期:1995-02-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-010-2026-y
更新日期:2010-12-01 00:00:00
abstract:PURPOSE:Neurologic and endothelial injury biomarkers are associated with prolonged delirium during critical illness and may reflect injury pathways that lead to poor long-term outcomes. We hypothesized that blood-brain barrier (BBB), neuronal, and endothelial injury biomarkers measured during critical illness are assoc...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-018-5120-1
更新日期:2018-03-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2007-07-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-014-3248-1
更新日期:2014-05-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254776
更新日期:1985-01-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2005-03-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2017-10-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2007-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2003-10-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:1998-07-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2006-11-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00256262
更新日期:1984-01-01 00:00:00
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更新日期:2010-06-01 00:00:00