Monitoring diaphragm activity and neuromechanical efficiency during acute respiratory failure: feasibility and preliminary findings
نویسندگان
چکیده
Methods Patients requiring invasive mechanical ventilation due to sepsis, ARDS, or severe acute brain injury were enrolled within 24 hours of intubation. Airway pressure, flow, crural diaphragm EMG activity (Edi) and transdiaphragmatic pressure (Pdi) were recorded for 5 minutes of every hour for up to 7 days. To assess for changes in diaphragm function, neuromechanical efficiency (NME ratio of Pdi/ Edi) was measured on a daily basis [3]. Diaphragm thickness (Tdi) and thickening fraction (TFdi) were measured once daily [4].
منابع مشابه
Diaphragmatic neuromechanical coupling and mechanisms of hypercapnia during inspiratory loading
We hypothesized that improved diaphragmatic neuromechanical coupling during inspiratory loading is not sufficient to prevent alveolar hypoventilation and task failure, and that the latter results primarily from central-output inhibition of the diaphragm and air hunger rather than contractile fatigue. Eighteen subjects underwent progressive inspiratory loading. By task failure all developed hype...
متن کاملThe calcium sensitizer levosimendan improves human diaphragm function.
RATIONALE Acquired diaphragm muscle weakness is a key feature in several chronic conditions, including chronic obstructive pulmonary disease, congestive heart failure, and difficult weaning from mechanical ventilation. No drugs are available to improve respiratory muscle function in these patients. Recently, we have shown that the calcium sensitizer levosimendan enhances the force-generating ca...
متن کاملNeuroventilatory efficiency and extubation readiness in critically ill patients
INTRODUCTION Based on the hypothesis that failure of weaning from mechanical ventilation is caused by respiratory demand exceeding the capacity of the respiratory muscles, we evaluated whether extubation failure could be characterized by increased respiratory drive and impaired efficiency to generate inspiratory pressure and ventilation. METHODS Airway pressure, flow, volume, breathing freque...
متن کاملEVENTRATION OF THE DIAPHRAGM: A 10- YEAR EXPERIENCE
Eventration of the diaphragm is a condition characterized by an attenuated but otherwise intact diaphragm. Twenty patients (age range: 2 days to 11 years) were treated for eventration of the diaphragm during a ten year period (19 85-1995). There were 11 girls and 9 boys with a mean gestational age of 37 weeks. 14 patients were born with cephalic presentation, 3 patients with breech deliver...
متن کاملElectrical activity of the diaphragm (EAdi) as a monitoring parameter in difficult weaning from respirator: a pilot study
INTRODUCTION A reliable prediction of successful weaning from respiratory support may be crucial for the overall outcome of the critically ill patient. The electrical activity of the diaphragm (EAdi) allows one to monitor the patients' respiratory drive and their ability to meet the increased respiratory demand. In this pilot study, we compared the EAdi with conventional parameters of weaning f...
متن کامل