Selek Çiğdem, Özcan Perihan Ergin, Orhun Günseli, Şentürk Evren, Akıncı İbrahim Özkan, Çakar Nahit
Department of Anaesthesiology and Reanimation, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.
Turk J Anaesthesiol Reanim. 2014 Apr;42(2):91-5. doi: 10.5152/TJAR.2014.95967. Epub 2014 Jan 6.
Automatic Tube Compensation (ATC) is a newly developed mechanical ventilatory support method. The aim of this study was to compare the ATC and the T-piece as a weaning method.
Patients who were treated in ICU with mechanical ventilation for longer than 24 hours were included in this prospective clinical study. Fifty patients were divided into two groups for weaning, ATC or T-piece group. Patients tolerating 30 minutes spontaneous breathing trial underwent immediate extubation. The following parameters were recorded just before the spontaneous breathing trial and every 5 minutes during the 30 minute period; PEEP, Pplt, Pmean, FiO2, heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate, SaO2, ETCO2. The primary outcome of the study was successful extubation defined as the ability to maintain spontaneous breathing for 48 hours after extubation.
The mean duration of weaning were 4.96 days and 7.42 days in the ATC and T-piece groups, respectively (p value 0.022). There were no significant differences between the groups with respect to the hemodynamic parameters, mechanical ventilation and gas exchange parameters.
In terms of success for weaning, there was no superiority between the ATC and the T-Piece methods for spontaneous breathing and it was concluded that each of the methods can be used for weaning. The ATC group were compared in terms of successful weaning period but have shown no significant periods of time were found to be lower.
自动管道补偿(ATC)是一种新开发的机械通气支持方法。本研究旨在比较ATC和T形管作为撤机方法的效果。
纳入在重症监护病房(ICU)接受机械通气超过24小时的患者进行这项前瞻性临床研究。50例患者分为两组进行撤机,即ATC组或T形管组。耐受30分钟自主呼吸试验的患者立即拔管。在自主呼吸试验前及试验期间的30分钟内每隔5分钟记录以下参数:呼气末正压(PEEP)、平台压(Pplt)、平均压(Pmean)、吸入氧分数(FiO2)、心率、收缩压、舒张压、呼吸频率、动脉血氧饱和度(SaO2)、呼气末二氧化碳分压(ETCO2)。本研究的主要结局是成功拔管,定义为拔管后能够维持48小时自主呼吸。
ATC组和T形管组的平均撤机时间分别为4.96天和7.42天(p值为0.022)。两组在血流动力学参数、机械通气和气体交换参数方面无显著差异。
就撤机成功率而言,ATC和T形管方法在自主呼吸方面没有优势,得出的结论是两种方法均可用于撤机。对ATC组在成功撤机时间方面进行了比较,但未发现显著更短的时间。