Baroreflex Sensitivity Evolution Before Weaning From Mechanical Ventilation

Abstract

Weaning is the process of withdrawing mechanical ventilation at the Intensive Care Units. The problem is that around 20% of weaned patients were not actually ready for discontinuation. Studies suggest that vagal dysfunction is lower in patients successfully weaned. Therefore, the Baroreflex Sensitivity (BRS) and Heart Rate Variability (HRV) are estimated to see if they can provide additional information to improve the prediction of weaning outcomes. 9 successfully weaned patients (S-group) and 6 unsuccessfully weaned (F-group) were monitored in the last hour prior to the Spontaneous Breathing Trial. The BRS is estimated through spectral analysis, to obtain the a parameter in the low and high frequency bands, and through the capacity, C, estimated by the Bivariate Phase Rectified Signal Average (BPRSA) method. The current clinic parameters of weaning readiness do not show statistical differences. However, the capacity to changes of the BRS, C, estimated via BPRSA, exhibits significant differences between the two groups. Negative values of C, and with higher absolute values, were obtained for the S-group. Temporal indices of HRV also show differences, but not significant. These results suggest that BRS should be further explored for predicting weaning outcomes.