Related factors of respiratory drive in patients with acute hypoxemic respiratory failure requiring mechanical ventilation during transition phase
Main Article Content
Abstract
Introduction: Abnormal respiratory drive can cause insufficient or unsafe ventilation (ventilator induced lung and diaphragm injury). Methods: retrospective screening patients with acute hypoxemic respiratory failure requiring mechanical ventilation with a transition phase. Respiratory drive was assessed by measuring airway occlusion pressure (P0.1). Clinical parameters, ventilator settings associated with P0.1 were evaluated. Results: 79 patients were switched from volume control ventilation to pressure support ventilation. Airway occlusion pressure median was 1.7 (1 - 2.5) cmH2O. Among them 55 (69.6%) had P0.1 within the range of lung-diaphragm protection ventilation. Clinical factors associated with P0.1 were ventilatory ratio (β = 0.35, IR = 1.42) and pressure support level (β = -0.31, IR = 0.73). RASS score was not associated with P0.1 in both univariate and multivariate analysis. Patients with lung-diaphragm protection ventilation had shorter total mechanical time -8.91 days (6.04 - 12.09) than patients without lung-diaphragm ventilation- 12.41 days (6.59 - 22.95) (not statistical significance). Conclusion: clinical factors associated with respiratory drive during transition phase are ventilatory ratio and pressure support level. RASS score is not associated with respiratory drive. The majority of patients required lung-diaphragm protection ventilation but this was not associated with shorter ventilation time.
Article Details
Keywords
Transition phase, airway occlusion pressure, lung−diaphragm protection ventilation
References
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