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Volume 3 Supplement 1

ESICM LIVES 2015

  • Poster presentation
  • Open Access

Spontaneous breathing test conducted with and without automatic tube compensation does not differ from a metabolic standpoint

  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 2 and
  • 1
Intensive Care Medicine Experimental20153 (Suppl 1) :A668

https://doi.org/10.1186/2197-425X-3-S1-A668

  • Published:

Keywords

  • Oxygen
  • Intensive Care Unit
  • Carbon Dioxide
  • Energy Expenditure
  • Mechanical Ventilation

Introduction

Weaning from mechanical ventilation is defined as the process of release of ventilatory support and how the evaluation of this phase is conducted in the Spontaneous Breathing Test (SBT). One of the most used modes of SBT is the Continuous Positive Airway Pressure (CPAP). However, together with the mechanical ventilation modes it can be used the Automatic Tube Compensation (ATC), which compensates the resistance imposed by the endotracheal tube.

Objectives

The main goal of this study was to compare the Oxygen Consumption (VO2), Carbon Dioxide Production (VCO2) and Energy Expenditure (EE) by Indirect Calorimetry (IC) during the SBT in CPAP with and without ATC.

Methods

The study was a prospective randomized, controlled crossover trial that enrolled 40 patients admitted to the Intensive Care Unit of a University Hospital. Participants were randomly allocated in Group 1, in which it was started the SBT in CPAP with ATC and later in CPAP without ATC, or in Group 2, which was started the SBT in CPAP without ATC and then CPAP with ATC.

Results

Table 1 and graph 1 summarize the differences between the treatments ATC and without ATC concerning metabolic and respiratory variables.

Table 1

VARIABLES

ESTIMATED DIFFERENCES BETWEEN THE ATC AND WITHOUT ATC

p VALUE

95% CONFIDENCE INTERVAL

VO2 (Oxygen Consumption) (mL/kg.min-¹)

-1.6

0.23

[ -4.36; 1.07 ]

EE (Energy Expenditure) (kcal/day-¹)

-5.4

0.500

[ -21.67; 10.79 ]

VCO2 (Carbon Dioxide Production) (mL/kg.min-¹)

0.3

0.82

[ -2.49; 3.11 ]

RQ (Respiratory Quotient)

0.0004

0.63

[ -0.01; 0.02 ]

Peak pressure (cm H20)

2.00

0.0001

[1.39; 2.62]

Tidal volume (mL)

13.32

0.5415

[ -30.65; 57.30 ]

Respiratory rate (bpm)

0.34

0.5688

[ -0.87; 1.56 ]

P0.1 -Airway occlusion pressure 100 milliseconds after onset of inspiratory flow (cm H2O)

-0.49

0.0073

[ -0.84; -0.14 ]

Conclusions

There were no metabolic differences evidenced by indirect calorimetry for VO2, EE and VCO2 during the SBT with and without ATC.

Figure 1

Authors’ Affiliations

(1)
Ribeirão Preto Medical School, University of São Paulo, Department of Surgery and Anatomy, Ribeirão Preto, Brazil
(2)
Ribeirão Preto Medical School, University of São Paulo, Physiotherapy Department, Ribeirão Preto, Brazil

References

  1. Dos Santos LJ, Hoff FC, Condessa RL, Kaufmann ML, Vieira SR: Energy expenditure during weaning from mechanical ventilation: Is there any difference between pressure support and T-tube?. J Crit Care. 2011, 26: 34-41. 10.1016/j.jcrc.2010.05.032.PubMedView ArticleGoogle Scholar

Copyright

© Lago et al.; 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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