Time course of electrical activity of the diaphragm (EAdi) in the peri extubation period and its role as predictor of extubation failure in difficult to wean patients

Weaning patients from mechanical ventilation is crucial in the management of acute respiratory failure (ARF). Spontaneous breathing trials (SBT) are used to assess readiness for extubation, but extubation failure remains a challenge. Diaphragmatic function, measured by electrical activity of the dia...

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Detalles Bibliográficos
Autores: Parrilla-Gómez, Francisco José|||0000-0002-9770-2759, Roche-Campo, Ferran, Italiano, Stefano|||0000-0001-7775-284X, Parrilla-Gómez, Andrés, Morán Chorro, Indalecio|||0000-0001-5090-5260, Mancebo Cortes, Jordi|||0000-0003-3308-5410, Maraffi, Tommaso|||0000-0002-5287-6704
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:307363
Acceso en línea:https://ddd.uab.cat/record/307363
https://dx.doi.org/urn:doi:10.1186/s13054-024-05092-x
Access Level:acceso abierto
Palabra clave:Weaning
Extubation
Electrical activity of the diaphragm
Mechanical ventilation
Spontaneous breathing trial
Descripción
Sumario:Weaning patients from mechanical ventilation is crucial in the management of acute respiratory failure (ARF). Spontaneous breathing trials (SBT) are used to assess readiness for extubation, but extubation failure remains a challenge. Diaphragmatic function, measured by electrical activity of the diaphragm (EAdi), may provide insights into weaning outcomes. This prospective, observational study included difficult-to-wean patients undergoing invasive mechanical ventilation. EAdi was recorded before, during, and after extubation. Patients were categorized into extubation success and failure groups based on reintubation within 48 h. Statistical analysis assessed EAdi patterns and predictive value. Thirty-one patients were analyzed, with six experiencing extubation failure. Overall, EAdi increased significantly between the phases before the SBT, the SBT and post-extubation period, up to 24 h (p < 0.001). EAdi values were higher in the extubation failure group during SBT (p = 0.01). An EAdi.

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