Effects of the First Spontaneous Breathing Trial in Children With Tracheostomy and Long-Term Mechanical Ventilation

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dc.catalogadorjwg
dc.contributor.authorVillarroel-Silva, Gregory
dc.contributor.authorJalil Contreras, Yorschua Frederick
dc.contributor.authorMoya-Gallardo, E.
dc.contributor.authorOyarzun Aguirre, Ignacio Javier
dc.contributor.authorMoscoso Altamira, Gonzalo Andrés
dc.contributor.authorAstudillo Maggio, Claudia Ester
dc.contributor.authorDamiani Rebolledo, Luis Felipe
dc.date.accessioned2023-12-06T19:43:23Z
dc.date.available2023-12-06T19:43:23Z
dc.date.issued2023
dc.description.abstractCopyright © 2023 by Daedalus Enterprises.BACKGROUND: Weaning and liberation from mechanical ventilation in pediatric patients with tracheostomy and long-term mechanical ventilation constitute a challenging process due to diagnosis heterogeneity and significant variability in the clinical condition. We aimed to evaluate the physiological response during the first attempt of a spontaneous breathing trial (SBT) and to compare variables in subjects who failed or passed the SBT. METHODS: This was a prospective observational study in tracheostomized children with long-term mechanical ventilation admitted to the Hospital Josefina Martinez, Santiago, Chile, between 2014-2020. Cardiorespiratory variables such as breathing pattern, use of accessory respiratory muscles, heart rate, breathing frequency, and oxygen saturation were registered at baseline and throughout a 2-h SBT with or without positive pressure depending on an SBT protocol. Comparison of demographic and ventilatory variables between groups (SBT failure and success) was performed. RESULTS: A total of 48 subjects were analyzed (median [IQR] age of 20.5 [17.0-35.0] months, 60% male). Chronic lung disease was the primary diagnosis in 60% of subjects. Eleven (23%) total subjects failed the SBT (< 2 h), with an average failure time of 69 ± 29 min. Subjects who failed the SBT had a significantly higher breathing frequency, heart rate, and end-tidal CO2 than subjects who succeeded (P < .001). In addition, subjects who failed the SBT had significantly shorter duration of mechanical ventilation before the SBT, higher proportion unassisted SBT, and higher rate of deviation SBT protocol in comparison with subjects who succeeded. CONCLUSIONS: Conducting an SBT to evaluate the tolerance and cardiorespiratory response in tracheostomized children with long-term mechanical ventilation is feasible. Time on mechanical ventilation before the first attempt and type of SBT (with or without positive pressure) could be associated with SBT failure.
dc.fechaingreso.objetodigital2023-12-06
dc.fuente.origenSCOPUS
dc.identifier.doi10.4187/respcare.10544
dc.identifier.issn19433654
dc.identifier.scopusidSCOPUS_ID:85171807179
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/75478
dc.information.autorucEscuela de Medicina; Jalil Contreras Yorschua Frederick; ; 1079709
dc.information.autorucEscuela de Medicina; Moscoso Altamira Gonzalo Andres; 0000-0001-7084-9171; 1032088
dc.information.autorucEscuela de Medicina; Oyarzun Aguirre Ignacio Javier; 0000-0002-8437-8814; 163700
dc.information.autorucEscuela de Medicina; Astudillo Maggio Claudia Ester; 0000-0002-3219-452X; 1014236
dc.information.autorucEscuela de Medicina; Damiani Rebolledo Luis Felipe; ; 237645
dc.language.isoen
dc.nota.accesoContenido parcial
dc.pagina.final1392
dc.pagina.inicio1385
dc.publisherNLM (Medline)
dc.revistaRespiratory care
dc.rightsacceso restringido
dc.subjectchildren
dc.subjectlong-term mechanical ventilation
dc.subjectspontaneous breathing trial
dc.subjecttracheostomy
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titleEffects of the First Spontaneous Breathing Trial in Children With Tracheostomy and Long-Term Mechanical Ventilation
dc.typeartículo
dc.volumen68
sipa.codpersvinculados1079709
sipa.codpersvinculados1032088
sipa.codpersvinculados163700
sipa.codpersvinculados1014236
sipa.codpersvinculados237645
sipa.trazabilidadSCOPUS;2023-10-15
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