Gastric intramucosal pH and intraluminal PCO2 during weaning from mechanical ventilation.

摘要: OBJECTIVE To study the value of gastric intramucosal pH and intraluminal PCO2 measurements to predict weaning outcome from mechanical ventilation. DESIGN Prospective clinical study. SETTING Intensive care medicine department a university hospital. PATIENTS Nineteen adult critically ill patients who were mechanically ventilated because acute respiratory failure considered ready be weaned. INTERVENTIONS The weaned with: synchronized intermittent mandatory ventilation plus positive end-expiratory pressure (SIMV+PEEP) or continuous airway with support (CPAP+PSV). A tonometer was placed in all patients. Tonometric, respiratory, hemodynamic variables measured during process. MEASUREMENTS Hemodynamic variables, mechanics, pulmonary gas exchange, muscle force, spontaneous pattern breathing, central control breathing recorded. Simultaneously, measured. MAIN RESULTS Eleven successfully extubated eight failed. failed showed higher values mouth occlusion pressure, rate, effective inspiratory impedance (mouth pressure/mean flow). initially 7.19 +/- 0.22 decreased 7.10 0.16 process (p < .05). At same time, nonsignificant change 7.36 0.07 7.32 extubated. statistically different when both groups compared initial final evaluations For evaluation, sensitivity specificity =7.30 0.88 (95% confidence interval [CI], 0.66-1) 0.82 CI, 0.59-1), respectively. When . =40 torr occurred 1 0.31-1) 0.55 0.26-0.84). CONCLUSIONS Weaning associated acidosis. may helpful outcome. Further controlled trials larger group are needed.