Prediction of successful ventilator weaning using airway occlusion pressure and hypercapnic challenge.


:We studied eleven patients during 14 attempts at weaning from mechanical ventilation to determine whether central ventilatory drive, measured as airway occlusion pressure 0.1 s after onset of inspiration (P 0.1), during spontaneous breathing before and during a brief hypercapnic challenge, could accurately predict the success or failure of the attempt. All patients were recovering from acute respiratory failure and could breathe spontaneously for 20 minutes on a T-piece but were judged clinically to be marginal weaning candidates. Minute ventilation (VI) and P 0.1 were measured while breathing spontaneously and were repeated during a hypercapnic challenge that raised end-tidal PCO2 approximately 10 mm Hg. Seven of the 14 weaning attempts were unsuccessful, requiring reinstitution of mechanical ventilation. Although the failure group had lower mean maximum inspiratory force and higher spontaneous respiratory rate, no threshold value separated the failure from the success group. Ventilation increased more during hypercapnic challenge in those patients whose weaning attempt was successful, but overlap of results between the two groups rendered this test inaccurate for predicting weaning success. In contrast, successfully weaned patients had greater augmentation of P 0.1 during hypercapnia, expressed as the ratio of P 0.1 during CO2-stimulated to P 0.1 during baseline values, than did those who failed weaning (p less than 0.005). This ratio succeeded, and was thus both specific and sensitive as a predictor of successful weaning from mechanical ventilation in these patients.






Montgomery AB,Holle RH,Neagley SR,Pierson DJ,Schoene RB




Has Abstract


1987-04-01 00:00:00
















  • ICU Admission Muscle and Fat Mass, Survival, and Disability at Discharge: A Prospective Cohort Study.

    abstract:BACKGROUND:Skeletal muscle dysfunction occurring as a result of ICU admission associates with higher mortality. Although preadmission higher BMI correlates with better outcomes, the impact of baseline muscle and fat mass has not been defined. We therefore investigated the association of skeletal muscle and fat mass at ...


    pub_type: 杂志文章


    authors: Jaitovich A,Khan MMHS,Itty R,Chieng HC,Dumas CL,Nadendla P,Fantauzzi JP,Yucel RM,Feustel PJ,Judson MA

    更新日期:2019-02-01 00:00:00

  • Migration and right atrial perforation of an Accufix atrial lead retention wire following partial lead removal during myomectomy.

    abstract::A 36-year-old man with a history of hypertrophic obstructive cardiomyopathy presented to the emergency room with "stabbing" chest pain. He had undergone dual-chamber pacemaker implantation in 1993 using an atrial lead (Accufix; Telectronics; Englewood, Colo) and a myomectomy in 1996 during which the distal portion of ...


    pub_type: 杂志文章


    authors: Gerstenfeld EP,Balarajan Y,Cooke R,Mittleman RS

    更新日期:1998-08-01 00:00:00

  • GI complications after lung transplantation in patients with cystic fibrosis.

    abstract:STUDY OBJECTIVE:Lung transplantation is now available for patients with cystic fibrosis (CF) and end-stage lung disease. While pulmonary graft function is often considered the major priority following transplantation, the nonpulmonary complications of this systemic disease also continue. We examined the GI complication...


    pub_type: 杂志文章


    authors: Gilljam M,Chaparro C,Tullis E,Chan C,Keshavjee S,Hutcheon M

    更新日期:2003-01-01 00:00:00

  • Long-term results of neoadjuvant ifosfamide, cisplatin, and etoposide combination in locally advanced non-small-cell lung cancer.

    abstract::Thirty-three patients with T3,N2,M0 or T4,N2,M0, non-small-cell lung cancer (NSCLC) took part in a phase 2 study in an attempt to evaluate the feasability of neoadjuvant chemotherapy followed by surgery and thoracic radiotherapy. Chemotherapy consisted of daily administration of the following treatment: etoposide, 100...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Pujol JL,Hayot M,Rouanet P,Le Chevalier T,Michel FB

    更新日期:1994-11-01 00:00:00

  • Almitrine decreases the distensibility of the large pulmonary arteries in man.

    abstract::Almitrine improves blood gas values in patients with COPD, primarily through better ventilation-perfusion matching. The improvement comes largely from a vasomotor effect of the drug. The vasomotor mechanism is unknown. We suspected that decreased distensibility of the large pulmonary arteries was one probable effect o...


    pub_type: 杂志文章


    authors: Herve P,Musset D,Simonneau G,Wagner W Jr,Duroux P

    更新日期:1989-09-01 00:00:00

  • Pleural biopsy with Cope and Abrams needles.

    abstract::The object of this study was to compare the diagnostic yield of Abrams and Cope needles. Pleural biopsies were performed in 24 patients with both needles. In two patients, the procedure was repeated within a few days. All patients had pleural effusion. The biopsies were performed at the same time; the biopsy sites wer...


    pub_type: 杂志文章


    authors: Morrone N,Algranti E,Barreto E

    更新日期:1987-12-01 00:00:00

  • Comparison of titanium vascular closure staples with suture repair of the thoracic aorta in swine.

    abstract:OBJECTIVE:Devices that reduce technical difficulty and anastigmatic time when repairing large vessels such as the thoracic aorta would be beneficial. The aim of this study was to determine if titanium vascular closure staples (3 mm) could be safely and quickly applied in the repair of large vessels such as the thoracic...


    pub_type: 杂志文章


    authors: Deb S,Martin B,Sun L,Burris D,Wherry D,Pikoulis E,Rhee P

    更新日期:2000-12-01 00:00:00

  • Targeted Fluid Minimization Following Initial Resuscitation in Septic Shock: A Pilot Study.

    abstract:BACKGROUND:IV fluid represents a basic therapeutic intervention for septic shock. Unfortunately, the optimal administration of IV fluid to maximize patient outcomes and prevent complications is largely unknown. METHODS:Patients with septic shock admitted to the medical ICUs of Barnes-Jewish Hospital (January to Decemb...


    pub_type: 杂志文章,随机对照试验


    authors: Chen C,Kollef MH

    更新日期:2015-12-01 00:00:00

  • Critical care rationing: international comparisons.

    abstract::Every country has finite resources that are expended to provide citizens with social "goods," including education, protection, infrastructure, and health care. Rationing-of any resource-refers to distribution of an allotted amount and may involve withholding some goods that would benefit some citizens. Health-care rat...


    pub_type: 杂志文章,评审


    authors: Evans TW,Nava S,Mata GV,Guidet B,Estenssoro E,Fowler R,Scheunemann LP,White D,Manthous CA

    更新日期:2011-12-01 00:00:00

  • Immediate hypersensitivity to tuberculin. In vivo and in vitro studies.

    abstract::Immediate responses of hypersensitivity to skin testing with purified derivative of tuberculin (PPD) were observed in 2.3 percent of 3,248 patients seen in an allergy clinic, and the relationship to delayed responses was questioned. Immediate cutaneous reactions to testing with PPD appeared in all age groups and occur...


    pub_type: 杂志文章


    authors: Tarlo SM,Day JH,Mann P,Day MP

    更新日期:1977-01-01 00:00:00

  • Venous air embolism. Diagnosis by spontaneous right-sided contrast echocardiography.

    abstract::This report describes the definitive diagnosis of venous air-embolism by documentation of spontaneous echo contrast in the right cardiac chambers following removal of a jugular venous catheter in a patient with hepatic failure. This complication was potentiated by the presence of concurrent hepatic coagulopathy which ...


    pub_type: 杂志文章


    authors: Marcus RH,Weinert L,Neumann A,Borow KM,Lang RM

    更新日期:1991-03-01 00:00:00

  • The relationship between left ventricular function assessed by multigated radionuclide test and cardiopulmonary exercise test in patients with ischemic heart disease.

    abstract:STUDY OBJECTIVES:To compare the oxygen pulse curve (O(2)P-C) as measured during cardiopulmonary exercise testing (CPET) with left ventricular (LV) ejection fraction (LVEF) rest-exercise response as measured by multigated equilibrium (99m)Tc radionuclide cineangiography (MUGA) in patients with different degrees of ische...


    pub_type: 杂志文章


    authors: Klainman E,Fink G,Lebzelter J,Krelbaumm T,Kramer MR

    更新日期:2002-03-01 00:00:00

  • Increased major bleeding complications related to triple antithrombotic therapy usage in patients with atrial fibrillation undergoing percutaneous coronary artery stenting.

    abstract:BACKGROUND:The optimal antithrombotic therapy strategy for atrial fibrillation (AF) patients who undergo percutaneous coronary intervention with stent implantation (PCI-S) is unknown. We assessed the safety of antithrombotic therapy strategies in AF patients with indication for oral anticoagulation (OAC) undergoing PCI...


    pub_type: 杂志文章


    authors: Manzano-Fernández S,Pastor FJ,Marín F,Cambronero F,Caro C,Pascual-Figal DA,Garrido IP,Pinar E,Valdés M,Lip GYH

    更新日期:2008-09-01 00:00:00

  • Massive hemoptysis from a pulmonary artery aneurysm associated with an emphysematous bulla.

    abstract::A 66-year-old man with a history of COPD and Aspergillus fumigatus infection developed massive hemoptysis. Pulmonary artery angiography revealed an aneurysm which was successfully treated with coil embolization. This is the first known report of a pulmonary artery aneurysm causing massive hemoptysis in a patient with ...


    pub_type: 杂志文章


    authors: Bowler RP,Durham J,Schwarz MI

    更新日期:1998-04-01 00:00:00

  • Diagnostic accuracy of coronary angiography utilizing computer-based digital subtraction methods. Comparison to conventional cineangiography.

    abstract::To evaluate the efficacy of mask-mode digital subtraction angiography in selective coronary arteriography, we compared computer-based digital subtraction angiograms to standard film-based angiograms in 77 patients. Digital angiography was performed utilizing a 512(2) matrix and a framing rate of 30 frames/second. Radi...


    pub_type: 杂志文章


    authors: Goldberg HL,Moses JW,Fisher J,Tamari I,Borer JS

    更新日期:1986-12-01 00:00:00

  • Multicentric endobronchial granular cell myoblastoma.

    abstract::Granular cell myoblastoma (GCM) is a rare benign neoplasm involving the tracheobronchial tree. It is believed to arise from the Schwann cell. Four cases of tracheobronchial GCM, all of which were multicentric, are presented and a conservative therapeutic approach is suggested. ...


    pub_type: 杂志文章


    authors: Redjaee B,Rohatgi PK,Herman MA

    更新日期:1990-10-01 00:00:00

  • Bronchial intraepithelial neoplasia/early central airways lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition).

    abstract:BACKGROUND:An evidence-based approach is necessary for the localization and management of intraepithelial and microinvasive non-small cell lung cancer in the central airways. METHODS:Material appropriate to this topic was obtained by literature search of a computerized database. Recommendations were developed by the w...


    pub_type: 杂志文章,实务指引


    authors: Kennedy TC,McWilliams A,Edell E,Sutedja T,Downie G,Yung R,Gazdar A,Mathur PN,American College of Chest Physicians.

    更新日期:2007-09-01 00:00:00

  • Immediate operative treatment for massive hemoptysis.

    abstract::A series of 15 patients with life threatening, massive hemoptysis is reported. Thirteen of these patients underwent immediate operative treatment with only three deaths. One died after bronchoscopic identification of the bleeding site while awaiting elective thoracotomy. The other patient left the hospital against med...


    pub_type: 杂志文章


    authors: McCollun WB,Mattox KL,Guinn GA,Beall AC Jr

    更新日期:1975-02-01 00:00:00

  • Left ventricular laceration due to stented prosthesis.

    abstract::Complications following open chest massage in patients with porcine xenografts in the mitral location have not been previously described. The authors report a case of cardiac resuscitation following mitral valve replacement with a stented porcine valve. The patient died following brief closed chest, and then, prolonge...


    pub_type: 杂志文章


    authors: Wild LM,Lajos TZ,Lee AB Jr,Wright J

    更新日期:1980-02-01 00:00:00

  • The Future of Lung Transplantation.

    abstract::The field of lung transplant has made significant advances over the last several decades. Despite these advances, morbidity and mortality remain high when compared with other solid organ transplants. As the field moves forward, the speed by which progress can be made will in part be determined by our ability to overco...


    pub_type: 杂志文章,评审


    authors: Young KA,Dilling DF

    更新日期:2019-03-01 00:00:00

  • Paradoxical trough effects of triple therapy with budesonide/formoterol and tiotropium bromide on pulmonary function outcomes in COPD.

    abstract:BACKGROUND:Lowest receptor occupancy for a drug occurs at trough prior to the next dose. Previous studies have focused on the effects of triple therapy at peak dose intervals using forced expiratory maneuvers. Impulse oscillometry (IOS) and body plethysmography (PLETH) are more sensitive than spirometry to assess inhal...


    pub_type: 杂志文章,随机对照试验


    authors: Williamson PA,Short PM,Clearie KL,Vaidyanathan S,Fardon TC,Howaniec LJ,Lipworth BJ

    更新日期:2010-09-01 00:00:00

  • Budesonide/formoterol maintenance plus reliever therapy: a new strategy in pediatric asthma.

    abstract:OBJECTIVES:A fixed combination of long-acting beta(2)-agonists (LABA) plus inhaled corticosteroids (ICS) has never been proven to reduce asthma exacerbations vs ICS alone in children. This 12-month, double-blind, randomized study in 341 children (age range, 4 to 11 years) with asthma uncontrolled on ICS investigated wh...


    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Bisgaard H,Le Roux P,Bjåmer D,Dymek A,Vermeulen JH,Hultquist C

    更新日期:2006-12-01 00:00:00

  • Macrolides: a treatment alternative for bronchiolitis obliterans organizing pneumonia?

    abstract::Some macrolides have been found to exert anti-inflammatory effects. Lung diseases such as asthma, panbronchiolitis, cystic fibrosis, and bronchiectasis are thought to respond to the immunomodulatory properties of macrolides. We report three cases of idiopathic bronchiolitis obliterans organizing pneumonia, now called ...


    pub_type: 杂志文章


    authors: Stover DE,Mangino D

    更新日期:2005-11-01 00:00:00

  • Mask proportional assist vs pressure support ventilation in patients in clinically stable condition with chronic ventilatory failure.

    abstract:OBJECTIVE:To compare the short-term physiologic effects of mask pressure support ventilation (PSV) and proportional assist ventilation (PAV) in patients in clinically stable condition with chronic ventilatory failure (CVF). DESIGN:Randomized, controlled physiologic study. SETTING:Lung function units of two pulmonary ...


    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Porta R,Appendini L,Vitacca M,Bianchi L,Donner CF,Poggi R,Ambrosino N

    更新日期:2002-08-01 00:00:00

  • A 3-month-old infant with recurrent apparent life-threatening events in a car seat.

    abstract::A 3-month-old infant was brought to clinic for evaluation of recurrent apparent life-threatening events (ALTEs). Two ALTE episodes occurred while the infant was sleeping in a safety car seat. The first one occurred when he was 4 weeks old. His mother noticed that he was not breathing; he appeared limp with full body c...


    pub_type: 杂志文章


    authors: DelRosso LM

    更新日期:2015-04-01 00:00:00

  • Differential response in the male and female tracheal epithelium following exposure to tobacco smoke.

    abstract::Histochemical quantification of goblet cells and measurements of the epithelial thickness were made in the trachea of male and female rats exposed to fresh whole tobacco smoke for 30 consecutive days. Exposure to tobacco smoke resulted in an increase in the total goblet cell count in both sexes, with the female rats d...


    pub_type: 杂志文章


    authors: Hayashi M,Sornberger GC,Huber GL

    更新日期:1978-04-01 00:00:00

  • Changes in cerebral oxygenation and hemodynamics during obstructive sleep apneas.

    abstract:OBJECTIVE:To evaluate changes in cerebral tissue oxygenation and blood volume during obstructive sleep apnea (OSA). METHODS:We studied eight men with moderate to severe OSA by near-infrared spectroscopy (NIRS) simultaneously with polysomnography during nocturnal sleep (five patients) and daytime naps (three). RESULTS...


    pub_type: 杂志文章


    authors: Hayakawa T,Terashima M,Kayukawa Y,Ohta T,Okada T

    更新日期:1996-04-01 00:00:00

  • Loculated interlobar air-fluid collection in congestive heart failure.

    abstract::Two patients are described who had congestive heart failure with loculated interlobar air-fluid collections. Although pseudotumor (interlobar effusion) is a well-known finding in congestive heart failure, the additional presence of air is unique. Both are somewhat related to the underlying failure. ...


    pub_type: 杂志文章


    authors: Rabinowitz JG,Kongtawng T

    更新日期:1978-12-01 00:00:00

  • Palliation of massive hemoptysis from unresectable carcinoma of the lung.

    abstract::Unresectable carcinoma of the lung has traditionally been recognized as a contraindication to surgery in massive hemoptysis. A 60-year-old man had massive hemoptysis. At surgery an unresectable neoplastic mass invading the mediastinum and great vessels was encountered. Subtotal resection was accomplished using a stapl...


    pub_type: 杂志文章


    authors: Hargrove WC 3rd,Harken AH

    更新日期:1979-08-01 00:00:00

  • Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking.

    abstract:STUDY OBJECTIVE:To determine the indications for preoperative localization of a small indeterminate pulmonary nodule. DESIGN:In this retrospective study, univariate and multivariate analyses were performed by the logistic regression procedure. SETTING:A single National Cancer Center Hospital in Japan. PATIENTS:A ser...


    pub_type: 杂志文章


    authors: Suzuki K,Nagai K,Yoshida J,Ohmatsu H,Takahashi K,Nishimura M,Nishiwaki Y

    更新日期:1999-02-01 00:00:00