Duration of diaphragmatic inactivity after endotracheal intubation of critically ill patients

Simple item page
dc.contributor.authorSklar, Michael Chaim
dc.contributor.authorDamiani Rebolledo, L. Felipe
dc.contributor.authorMadotto, Fabiana
dc.contributor.authorJonkman, Annemijn
dc.contributor.authorRauseo, Michela
dc.contributor.authorSoliman, Ibrahim
dc.contributor.authorTelias, Irene
dc.contributor.authorDubo, Sebastian
dc.contributor.authorChen, Lu
dc.contributor.authorRittayamai, Nuttapol
dc.date.accessioned2021-01-19T12:00:04Z
dc.date.available2021-01-19T12:00:04Z
dc.date.issued2021
dc.date.updated2021-01-17T01:03:39Z
dc.description.abstractAbstract Background In patients intubated for mechanical ventilation, prolonged diaphragm inactivity could lead to weakness and poor outcome. Time to resume a minimal diaphragm activity may be related to sedation practice and patient severity. Methods Prospective observational study in critically ill patients. Diaphragm electrical activity (EAdi) was continuously recorded after intubation looking for resumption of a minimal level of diaphragm activity (beginning of the first 24 h period with median EAdi > 7 µV, a threshold based on literature and correlations with diaphragm thickening fraction). Recordings were collected until full spontaneous breathing, extubation, death or 120 h. A 1 h waveform recording was collected daily to identify reverse triggering. Results Seventy-five patients were enrolled and 69 analyzed (mean age ± standard deviation 63 ± 16 years). Reasons for ventilation were respiratory (55%), hemodynamic (19%) and neurologic (20%). Eight catheter disconnections occurred. The median time for resumption of EAdi was 22 h (interquartile range 0–50 h); 35/69 (51%) of patients resumed activity within 24 h while 4 had no recovery after 5 days. Late recovery was associated with use of sedative agents, cumulative doses of propofol and fentanyl, controlled ventilation and age (older patients receiving less sedation). Severity of illness, oxygenation, renal and hepatic function, reason for intubation were not associated with EAdi resumption. At least 20% of patients initiated EAdi with reverse triggering. Conclusion Low levels of diaphragm electrical activity are common in the early course of mechanical ventilation: 50% of patients do not recover diaphragmatic activity within one day. Sedatives are the main factors accounting for this delay independently from lung or general severity. Trial Registration ClinicalTrials.gov (NCT02434016). Registered on April 27, 2015. First patients enrolled June 2015.
dc.format.extent15 páginas
dc.identifier.citationCritical Care. 2021 Jan 11;25(1):26
dc.identifier.doi10.1186/s13054-020-03435-y
dc.identifier.urihttps://doi.org/10.1186/s13054-020-03435-y
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/51208
dc.issue.numeroNo. 26
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final15
dc.pagina.inicio1
dc.revistaCritical Carees_ES
dc.rightsacceso abierto
dc.rights.holderThe Author(s)
dc.subjectMechanical ventilationes_ES
dc.subjectDiaphragmes_ES
dc.subjectElectrical activity of the diaphragmes_ES
dc.subjectSedationes_ES
dc.subjectCritical carees_ES
dc.subject.ddc615.83620284
dc.subject.deweyMedicina y saludes_ES
dc.titleDuration of diaphragmatic inactivity after endotracheal intubation of critically ill patientses_ES
dc.typeartículo
dc.volumenVol. 25
sipa.codpersvinculados237645
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
13054_2020_Article_3435.pdf
Size:
3.08 MB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
0 B
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Artículos de revistas