Decreased breathing variability is associated with poorer outcome in mechanically ventilated patients.
Journal
ERJ open research
ISSN: 2312-0541
Titre abrégé: ERJ Open Res
Pays: England
ID NLM: 101671641
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
26
10
2022
accepted:
09
02
2023
medline:
5
5
2023
pubmed:
5
5
2023
entrez:
5
5
2023
Statut:
epublish
Résumé
Breathing is a cyclic activity that is variable by nature. Breathing variability is modified in mechanically ventilated patients. We aimed to evaluate whether decreased variability on the day of transition from assist-control ventilation to a partial mode of assistance was associated with a poorer outcome. This was an ancillary study of a multicentre, randomised, controlled trial comparing neurally adjusted ventilatory assist to pressure support ventilation. Flow and the electrical activity of the diaphragm (EAdi) were recorded within 48 h of switching from controlled ventilation to a partial mode of ventilatory assistance. Variability of flow and EAdi-related variables were quantified by the coefficient of variation, the amplitude ratio of the spectrum's first harmonic to its zero-frequency component (H1/DC) and two surrogates of complexity. 98 patients ventilated for a median duration of 5 days were included. H1/DC of inspiratory flow and EAdi were lower in survivors than in nonsurvivors, suggesting a higher breathing variability in this population (for flow, 37% Higher breathing variability and lower complexity are associated with higher survival and lower duration of mechanical ventilation.
Identifiants
pubmed: 37143829
doi: 10.1183/23120541.00544-2022
pii: 00544-2022
pmc: PMC10152249
pii:
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright ©The authors 2023.
Déclaration de conflit d'intérêts
Conflict of interest: T. Similowski reports grants or contracts from Chiesi France and Air Liquide Medical Systems, outside the submitted work; consulting fees from AstraZeneca France, Boerhinger Ingelheim France, Novartis France, TEVA France, Chiesi France, Lungpacer Inc. and ADEP Assistance, outside the submitted work; and payment or honoraria from AstraZeneca France, Boehringer Ingelheim France, Novartis France, TEVA France, Chiesi France, Lungpacer Inc. and ADEP Assistance, outside the submitted work. Conflict of interest: A. Demoule reports grants or contracts from Philips, Fisher & Paykel, French Ministry of Health, Respinor and Lungpacer, outside the submitted work; consulting fees from Lungpacer and Respinor, outside the submitted work; payment or honoraria from Fisher & Paykel, Getinge, Lungpacer, Gilead, Lowenstein and Astra, outside the submitted work; and support for attending meetings and/or travel from Lungpacer, outside the submitted work. Conflict of interest: The remaining authors have nothing to disclose.
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