The control of breathing during weaning from mechanical ventilation

W. F. Dunn, S. B. Nelson, R. D. Hubmayr

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Using the recruitment threshold technique, we measured the CO 2 responsiveness of the unloaded respiratory pump in 14 mechanically ventilated patients prior to weaning. The CO 2 recruitment threshold (CO 2RT) was compared with the arterial CO 2 tension during unassisted breathing (CO 2SB) and with the PaCO 2 during mechanical ventilation (CO 2MV) at machine settings determined by the primary physician. Based on these comparisons, we tested the hypotheses that (1) patients without weaning-induced respiratory distress (group 1) maintain CO 2SB near CO 2RT, (2) patients with weaning-induced respiratory distress (group 2) retain CO 2SB above CO 2RT, thereby manifesting incomplete load compensation, and (3) CO 2MV is ventilator setting dependent and provides insufficient information about the ventilatory requirement during weaning. Respiratory distress was prospectively defined as sustained tachypnea (rate≥30) or intense dyspnea (Borg scale rating) and limited weaning in nine of 14 patients. The average CO 2RT was 40 mm Hg in both groups. All patients in group 1 maintained CO 2SB near CO 2RT (p>0.1). Seven of nine patients in group 2 retained CO 2 by ≥3 mm Hg above CO 2RT (p<0.01). There was no significant difference between CO 2MV and CO 2SB in either group. We conclude that CO 2RT provides a better reference of the adequacy of ventilatory load compensation during weather than CO 2MV.

Original languageEnglish (US)
Pages (from-to)754-761
Number of pages8
JournalChest
Volume100
Issue number3
StatePublished - 1991

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Carbon Monoxide
Artificial Respiration
Respiration
Weaning
Tachypnea
Weather
Mechanical Ventilators

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Dunn, W. F., Nelson, S. B., & Hubmayr, R. D. (1991). The control of breathing during weaning from mechanical ventilation. Chest, 100(3), 754-761.

The control of breathing during weaning from mechanical ventilation. / Dunn, W. F.; Nelson, S. B.; Hubmayr, R. D.

In: Chest, Vol. 100, No. 3, 1991, p. 754-761.

Research output: Contribution to journalArticle

Dunn, WF, Nelson, SB & Hubmayr, RD 1991, 'The control of breathing during weaning from mechanical ventilation', Chest, vol. 100, no. 3, pp. 754-761.
Dunn WF, Nelson SB, Hubmayr RD. The control of breathing during weaning from mechanical ventilation. Chest. 1991;100(3):754-761.
Dunn, W. F. ; Nelson, S. B. ; Hubmayr, R. D. / The control of breathing during weaning from mechanical ventilation. In: Chest. 1991 ; Vol. 100, No. 3. pp. 754-761.
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