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J Crit Care. 2017 Jun;39:178-181. doi: 10.1016/j.jcrc.2017.02.033. Epub 2017 Feb 28.

Correlation between transition percentage of minute volume (TMV%) and outcome of patients with acute respiratory failure.

Author information

1
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Electronic address: kanpeng@ndmctsgh.edu.tw.
2
Department of Critical Care Medicine, Taiwan Landseed Hospital, National Central University, Taoyuan 32449, Taiwan.
3
Department of Respiratory Therapy, Fu Jen Catholic University, New Taipei, Taiwan. Electronic address: 075147@mail.fju.edu.tw.
4
Department of Critical Care Medicine, Taiwan Landseed Hospital, National Central University, Taoyuan 32449, Taiwan. Electronic address: hsiehcf@landseed.com.tw.
5
Department of Critical Care Medicine, Taiwan Landseed Hospital, National Central University, Taoyuan 32449, Taiwan. Electronic address: huangcc@landseed.com.tw.
6
Division of Pulmonary, Allergy and Critical Care Medicine, Duke University Medical Center, Chapel Hill, NC, USA. Electronic address: yuhchin.huang@duke.edu.
7
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Critical Care Medicine, Taiwan Landseed Hospital, National Central University, Taoyuan 32449, Taiwan. Electronic address: wucp@landseed.com.tw.

Abstract

PURPOSE:

We have previously shown in patients receiving adaptive support ventilation (ASV) that there existed a Transition %MinVol (TMV%) where the patient's work of breathing began to reduce. In this study, we tested the hypothesis that higher TMV% would be associated with poorer outcome in patients with acute respiratory failure.

MATERIALS AND METHODS:

In this prospective observational study, we recruited patients with acute respiratory failure on ASV between December 2012 and September 2013 in a mixed ICU. The TMV% was determined by adjusting % MinVol until mandatory respiratory frequency was between 0 and 1breath/min. TMV% was measured on the first two days of mechanical ventilation.

RESULTS:

A total of 337 patients (age: 70±16years) were recruited. In patients whose TMV% increased between Day 1 and Day 2, aOR for mortality was 7.0 (95%CI=2.7-18.3, p<0.001) compared to patients whose TMV% decreased. In patients whose TMV% was unchanged between Day 1 and Day2, aOR for mortality was 3.91 (95%CI=1.80-8.22, p<0.01).

CONCLUSIONS:

An increase, or lack of decrease, of TMV% from Day 1 to Day 2 was associated with higher risk of in-hospital death.

KEYWORDS:

Mechanical ventilation; Minute volume; Mortality; Optimal minute volume; Outcome; Weaning

PMID:
28278435
DOI:
10.1016/j.jcrc.2017.02.033
[Indexed for MEDLINE]

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