Breathing pattern variability: A weaning predictor in postoperative patients recovering from systemic inflammatory response syndrome

Mauo Ying Bien, Shu Shya Hseu, Huey Wen Yien, Benjamin Ing Tiau Kuo, Yu Ting Lin, Jia Horng Wang, Yu Ru Kou

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

Objective: To investigate whether breathing pattern variability can serve as a potential weaning predictor for postoperative patients recovering from systemic inflammatory response syndrome (SIRS). Design and setting: A prospective measurement of retrospectively analyzed breathing pattern variability in a surgical intensive care unit. Patients: Seventy-eight mechanically ventilated SIRS patients who had undergone abdominal surgery were included when they were ready for weaning. They were divided into success (n=57) and failure (n=21) groups based upon their weaning outcome. Measurements and results: Before weaning, tidal volume, total breath duration, inspiratory time, expiratory time, and peak inspiratory flow were continuously monitored for 30 min, while patients received 5 CmH2O pressure support weaning trial. After the patients successfully completed the trial, they were extubated. Successful weaning was defined as patients free from the ventilator for over 48 h, whereas a weaning failure was considered as reinstitution of mechanical ventilation within 48 h of extubation. The coefficient of variation and two values of standard deviation (SD1 and SD2; indicators of the dispersion of data points in the plot) obtained from the Poincaré plot of five respiratory parameters in the failure group were significantly lower than those in the success group. The area under the receiver operating characteristic curve of these variability indices was within the range of 0.73-0.80, indicating the accuracy of prediction. Conclusions: Small breathing pattern variability is associated with a high incidence of weaning failure in post-operative patients recovering from SIRS, and this variability may potentially serve as a weaning predictor.

Original languageEnglish
Pages (from-to)241-247
Number of pages7
JournalIntensive Care Medicine
Volume30
Issue number2
DOIs
Publication statusPublished - Feb 2004
Externally publishedYes

Fingerprint

Systemic Inflammatory Response Syndrome
Weaning
Respiration
Tidal Volume
Mechanical Ventilators
Critical Care
Artificial Respiration
ROC Curve
Intensive Care Units
Pressure

Keywords

  • Postoperative care
  • Receiver operating characteristic curve
  • Respiratory center
  • Sepsis syndrome
  • Ventilator weaning
  • Ventilators, mechanical

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Breathing pattern variability : A weaning predictor in postoperative patients recovering from systemic inflammatory response syndrome. / Bien, Mauo Ying; Hseu, Shu Shya; Yien, Huey Wen; Kuo, Benjamin Ing Tiau; Lin, Yu Ting; Wang, Jia Horng; Kou, Yu Ru.

In: Intensive Care Medicine, Vol. 30, No. 2, 02.2004, p. 241-247.

Research output: Contribution to journalArticle

Bien, Mauo Ying ; Hseu, Shu Shya ; Yien, Huey Wen ; Kuo, Benjamin Ing Tiau ; Lin, Yu Ting ; Wang, Jia Horng ; Kou, Yu Ru. / Breathing pattern variability : A weaning predictor in postoperative patients recovering from systemic inflammatory response syndrome. In: Intensive Care Medicine. 2004 ; Vol. 30, No. 2. pp. 241-247.
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abstract = "Objective: To investigate whether breathing pattern variability can serve as a potential weaning predictor for postoperative patients recovering from systemic inflammatory response syndrome (SIRS). Design and setting: A prospective measurement of retrospectively analyzed breathing pattern variability in a surgical intensive care unit. Patients: Seventy-eight mechanically ventilated SIRS patients who had undergone abdominal surgery were included when they were ready for weaning. They were divided into success (n=57) and failure (n=21) groups based upon their weaning outcome. Measurements and results: Before weaning, tidal volume, total breath duration, inspiratory time, expiratory time, and peak inspiratory flow were continuously monitored for 30 min, while patients received 5 CmH2O pressure support weaning trial. After the patients successfully completed the trial, they were extubated. Successful weaning was defined as patients free from the ventilator for over 48 h, whereas a weaning failure was considered as reinstitution of mechanical ventilation within 48 h of extubation. The coefficient of variation and two values of standard deviation (SD1 and SD2; indicators of the dispersion of data points in the plot) obtained from the Poincar{\'e} plot of five respiratory parameters in the failure group were significantly lower than those in the success group. The area under the receiver operating characteristic curve of these variability indices was within the range of 0.73-0.80, indicating the accuracy of prediction. Conclusions: Small breathing pattern variability is associated with a high incidence of weaning failure in post-operative patients recovering from SIRS, and this variability may potentially serve as a weaning predictor.",
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