Elevated static compliance of the total respiratory system: Early predictor of weaning unsuccess in severe COPD patients mechanically ventilated

E. Zanotti, F. Rubini, G. Iotti, A. Braschi, A. Palo, C. Bruschi, C. Fracchia, S. Nava

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To assess in a group of COPD patients mechanically ventilated for an episode of acute respiratory failure the respiratory mechanics with a simple and non invasive method at the bedside in order to evaluate if these parameters may be predictive of weaning failure or success. Design: A prospective study. Setting: Intensive care and intermediate intensive care units. Patients: 23 COPD patients ventilated for acute respiratory failure and studied within 24 hours from intubation. Methods: Using end-expiratory and end-inspiratory airway occlusion technique, we measured PEEPi, static compliance of the respiratory system (Crs, st) maximum respiratory resistance (Rrsmax) and minimum respiratory resistance (Rrsmin). Measurements and results: The weaned group (A) and the not weaned group (B) were not different regarding to static PEEPi (group A 8.5±4.0 vs group B 8.9±2.6 cmH2O), to Rrsmax (22.4±5.3 versus 22.2±9.0 cmH2O/l/s) and to Rrsmin (17.6±5.5 versus 17.9±8.0 cmH2O/l/s), while a significant difference (p2O). The threshold value of 88.5 ml/cmH2O was identified by discriminant analysis and provided the best separation between the two groups, with a sensitivity of 0.85 and a specificity of 0.87. Conclusion: Cst, rs measured non invasively in the first 24 h from intubation, provided a good separation between the patients who were successfully weaned and those who failed.

Original languageEnglish
Pages (from-to)399-405
Number of pages7
JournalIntensive Care Medicine
Volume21
Issue number5
DOIs
Publication statusPublished - May 1995

Keywords

  • COPD
  • Respiratory mechanics
  • Weaning prediction

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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