重症监护病房机械通气患者的耗氧量、用力和脱机：拔管研究：一项观察性研究的方案。

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine Pub Date : 2025-02-01 DOI:10.1016/j.rmed.2025.107949

F.E. Smits, P.J. Rietveld, J.W.M. Snoep, F. van der Velde-Quist, E. de Jonge, A. Schoe

{"title":"重症监护病房机械通气患者的耗氧量、用力和脱机：拔管研究：一项观察性研究的方案。","authors":"F.E. Smits, P.J. Rietveld, J.W.M. Snoep, F. van der Velde-Quist, E. de Jonge, A. Schoe","doi":"10.1016/j.rmed.2025.107949","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>The spontaneous breathing trial (SBT) is often performed to determine whether the patient can be extubated with a minimal risk of failure. The rapid shallow breathing index (RSBI) is an important parameter used in an SBT. However, weaning failure rates are between 15 and 20 %. Because of the high incidence of extubation failure a search for a better parameter is warranted. The aim of this study is to investigate whether oxygen consumption, pressure-time product, work of breathing and pressure swings predict weaning failure.</div></div><div><h3>Methods</h3><div>This is a single-center, prospective observational study conducted at the Leiden University Medical Center. Adult patients undergoing an SBT as per the ruling protocol in the LUMC will be included. Measurements of oxygen consumption, pressure-time product, work of breathing and pressure swings will be continuously recorded during 10 min prior, during and 10 min after the SBT. Data collection will not interfere with clinical decision making. The primary outcome is the ability of these parameters to predict extubation success or failure.</div></div><div><h3>Discussion</h3><div>Patient enrollment started in January 2024 and inclusions are expected to be complete in January 2026. Patient's risk and burden are minimal. We hypothesize that patients who fail extubation will have higher absolute baseline efforts but will not have the potential to increase those efforts when subjected to an SBT.</div></div><div><h3>Trial registration</h3><div>The study is retrospectively registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> under identifier NCT06391424, submitted on 2024-04-30.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107949"},"PeriodicalIF":3.5000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Oxygen consumption, effort, and weaning in the mechanically ventilated patient in the intensive care unit: The extubate study: A protocol for an observational study\",\"authors\":\"F.E. Smits, P.J. Rietveld, J.W.M. Snoep, F. van der Velde-Quist, E. de Jonge, A. Schoe\",\"doi\":\"10.1016/j.rmed.2025.107949\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>The spontaneous breathing trial (SBT) is often performed to determine whether the patient can be extubated with a minimal risk of failure. The rapid shallow breathing index (RSBI) is an important parameter used in an SBT. However, weaning failure rates are between 15 and 20 %. Because of the high incidence of extubation failure a search for a better parameter is warranted. The aim of this study is to investigate whether oxygen consumption, pressure-time product, work of breathing and pressure swings predict weaning failure.</div></div><div><h3>Methods</h3><div>This is a single-center, prospective observational study conducted at the Leiden University Medical Center. Adult patients undergoing an SBT as per the ruling protocol in the LUMC will be included. Measurements of oxygen consumption, pressure-time product, work of breathing and pressure swings will be continuously recorded during 10 min prior, during and 10 min after the SBT. Data collection will not interfere with clinical decision making. The primary outcome is the ability of these parameters to predict extubation success or failure.</div></div><div><h3>Discussion</h3><div>Patient enrollment started in January 2024 and inclusions are expected to be complete in January 2026. Patient's risk and burden are minimal. We hypothesize that patients who fail extubation will have higher absolute baseline efforts but will not have the potential to increase those efforts when subjected to an SBT.</div></div><div><h3>Trial registration</h3><div>The study is retrospectively registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> under identifier NCT06391424, submitted on 2024-04-30.</div></div>\",\"PeriodicalId\":21057,\"journal\":{\"name\":\"Respiratory medicine\",\"volume\":\"237 \",\"pages\":\"Article 107949\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respiratory medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0954611125000113\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0954611125000113","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

目的：经常进行自主呼吸试验（SBT），以确定患者是否可以在最小的失败风险下拔管。快速浅呼吸指数（RSBI）是SBT的一个重要参数。然而，断奶失败率在15-20%之间。由于拔管失败的高发生率，寻找一个更好的参数是必要的。本研究的目的是探讨耗氧量、压力-时间乘积、呼吸功和压力波动是否能预测脱机失败。方法：这是一项在莱顿大学医学中心进行的单中心前瞻性观察研究。根据LUMC的裁决协议接受SBT的成年患者将包括在内。在SBT前、中、后十分钟内，连续记录耗氧量、压力-时间积、呼吸功和压力波动。数据收集不会干扰临床决策。主要结果是这些参数预测拔管成功或失败的能力。讨论：患者入组于2024年1月开始，预计纳入将于2026年1月完成。患者的风险和负担最小。我们假设拔管失败的患者将有更高的绝对基线努力，但在接受SBT时不会有增加这些努力的潜力。试验注册：该研究在ClinicalTrials.gov上回顾性注册，识别码为NCT06391424，于2024-04-30提交。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Oxygen consumption, effort, and weaning in the mechanically ventilated patient in the intensive care unit: The extubate study: A protocol for an observational study

Purpose

The spontaneous breathing trial (SBT) is often performed to determine whether the patient can be extubated with a minimal risk of failure. The rapid shallow breathing index (RSBI) is an important parameter used in an SBT. However, weaning failure rates are between 15 and 20 %. Because of the high incidence of extubation failure a search for a better parameter is warranted. The aim of this study is to investigate whether oxygen consumption, pressure-time product, work of breathing and pressure swings predict weaning failure.

Methods

This is a single-center, prospective observational study conducted at the Leiden University Medical Center. Adult patients undergoing an SBT as per the ruling protocol in the LUMC will be included. Measurements of oxygen consumption, pressure-time product, work of breathing and pressure swings will be continuously recorded during 10 min prior, during and 10 min after the SBT. Data collection will not interfere with clinical decision making. The primary outcome is the ability of these parameters to predict extubation success or failure.

Discussion

Patient enrollment started in January 2024 and inclusions are expected to be complete in January 2026. Patient's risk and burden are minimal. We hypothesize that patients who fail extubation will have higher absolute baseline efforts but will not have the potential to increase those efforts when subjected to an SBT.

Trial registration

The study is retrospectively registered at ClinicalTrials.gov under identifier NCT06391424, submitted on 2024-04-30.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.