PDF(Pubmed)
Abstract：
UNASSIGNED: To evaluate hemodynamic profiles of critical care patients undergoing spontaneous t-piece trial (SBT) and present weaning failure.
UNASSIGNED: Prospective observational study conducted in ready-to-wean non-cardiac ICU patients. Clinical, echocardiographic and thermodilution-derived variables were recorded before and after a 2-hour SBT. Weaning from mechanical ventilation was defined as preservation of spontaneous breathing for 48 hours following successful SBT.
UNASSIGNED: Fourteen patients succeeded weaning, five manifested T-trial-failure and six late-failure. Weaning outcome was significantly associated with ELWI(Extravascular lung-water index), global-end-diastolic index and impaired diastolic function, as indicated by pre-T Doppler early wave velocities (E/Em); Fifty-six percent of participants presented ELWI≥7mL/kg when fulfilling predetermined criteria for weaning. ELWI, impaired pulmonary permeability and left ventricular diastolic dysfunction were independent determinants of ELWI.
UNASSIGNED: ELWI before SBT and impaired diastolic function (as indicated by pre-T E/Em) might be weaning outcome determinants and their assessment may allow better risk stratification in weaning decision making.
UNASSIGNED: Prospective observational study conducted in ready-to-wean non-cardiac ICU patients. Clinical, echocardiographic and thermodilution-derived variables were recorded before and after a 2-hour SBT. Weaning from mechanical ventilation was defined as preservation of spontaneous breathing for 48 hours following successful SBT.
UNASSIGNED: Fourteen patients succeeded weaning, five manifested T-trial-failure and six late-failure. Weaning outcome was significantly associated with ELWI(Extravascular lung-water index), global-end-diastolic index and impaired diastolic function, as indicated by pre-T Doppler early wave velocities (E/Em); Fifty-six percent of participants presented ELWI≥7mL/kg when fulfilling predetermined criteria for weaning. ELWI, impaired pulmonary permeability and left ventricular diastolic dysfunction were independent determinants of ELWI.
UNASSIGNED: ELWI before SBT and impaired diastolic function (as indicated by pre-T E/Em) might be weaning outcome determinants and their assessment may allow better risk stratification in weaning decision making.
摘要：
■评估接受自发性t片试验（SBT）并出现断奶失败的重症监护患者的血液动力学特征。
■在非心脏ICU患者中进行的前瞻性观察性研究。临床,在2小时SBT之前和之后记录超声心动图和热稀释衍生变量。从机械通气中断奶被定义为在成功SBT后保持自主呼吸48小时。
■14名患者成功断奶，五个明显的T审判失败和六个后期失败。断奶结局与ELWI（血管外肺水指数）显著相关，整体舒张末期指数和舒张功能受损，如T前多普勒早期波速(E/Em)所示;当满足预定的断奶标准时,有56%的参与者出现ELWI≥7mL/kg.ELWI,肺通透性受损和左心室舒张功能不全是ELWI的独立决定因素.
■SBT之前的ELWI和舒张功能受损（如T前E/Em所示）可能是断奶结局的决定因素，其评估可以在断奶决策中进行更好的风险分层。
■在非心脏ICU患者中进行的前瞻性观察性研究。临床,在2小时SBT之前和之后记录超声心动图和热稀释衍生变量。从机械通气中断奶被定义为在成功SBT后保持自主呼吸48小时。
■14名患者成功断奶，五个明显的T审判失败和六个后期失败。断奶结局与ELWI（血管外肺水指数）显著相关，整体舒张末期指数和舒张功能受损，如T前多普勒早期波速(E/Em)所示;当满足预定的断奶标准时,有56%的参与者出现ELWI≥7mL/kg.ELWI,肺通透性受损和左心室舒张功能不全是ELWI的独立决定因素.
■SBT之前的ELWI和舒张功能受损（如T前E/Em所示）可能是断奶结局的决定因素，其评估可以在断奶决策中进行更好的风险分层。
