In COPD patients on prolonged mechanical ventilation heart rate variability during the T-piece trial is better after pressure support plus PEEP: a pilot physiological study.
|
| Abstract | OBJECTIVES: To evaluate heart rate variability (HRV), hemodynamics, mechanics, dyspnea and blood gases following different mechanical ventilation (MV) settings. BACKGROUND: No study has evaluated physiological changes during T-piece trials following different MV settings. METHODS: In 8 COPD patients on prolonged MV we applied in random order two MV settings: i) pressure support (PS) 20 cm H2O + positive end-expiratory pressure (PEEP) 0 cm H2O (setting-1) and ii) PS 15 cm H2O + PEEP 5 cm H2O (setting-2), each followed by a 30 min T-piece trial. RESULTS: Setting-1 induced greater minute ventilation, tidal volume/inspiratory time and lower pulmonary artery occlusion pressure; setting-2 reduced intrinsic PEEP. Mechanics and hemodynamics data did not differ, but all HRV time domain indices were reduced only after setting-1, suggesting a decreased parasympathetic and increased sympathetic cardiac modulation. CONCLUSIONS: The T-piece trial following setting-2 seems less stressful on neural control of HRV. Future studies on T-piece trials should consider the residual effect of the MV setting.
|
|---|---|
| Authors | Michele Vitacca, Simonetta Scalvini, Maurizio Volterrani, Enrico Maria Clini, Mara Paneroni, Amerigo Giordano, Nicolino Ambrosino |
| Journal | Heart & lung : the journal of critical care (Heart Lung) 2014 Sep-Oct Vol. 43 Issue 5 Pg. 420-6 ISSN: 1527-3288 [Electronic] United States |
| PMID | 24856229 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial) |
| Copyright | Copyright © 2014 Elsevier Inc. All rights reserved. |
| Topics |
|
Join CureHunter, for free Research Interface BASIC access!
Realize the full power of the drug-disease research graph!