Author Of 1 Presentation
AIRWAY OCCLUSION PRESSURES IN MECHANICALLY VENTILATED PAEDIATRIC PATIENTS: A PILOT STUDY
Abstract
Background
Prolonged duration of mechanical ventilation can be associated with complications and an increased risk of extubation failure. Adult studies showed that the maximal inspiratory pressure (MIP) and inspiratory occlusion pressure after 100ms (P100) can predict extubation outcome.
Objectives
To study the level and time course of MIP and P100 during mechanical ventilation in paediatrics and to study its clinical correlate.
Methods
Observational pilot-study in spontaneous breathing and mechanically ventilated children aged <18 years. MIP and P100 was measured during a maximum of five days before extubation. During an occlusion test available on the ventilator, the inspiratory valve was closed during 3-5 inspirations. This manoeuvre was repeated twice and the most negative value was considered as best of three.
Results
A total of 104 patients were included in this study. Median MIP and P100 on day of extubation was -16cm H2O (IQR -20 - -10) and -5cm H2O (-7 - -4), respectively. A significant improvement of MIP (p=0.036) on day of extubation was found. Ventilation duration did affect the level of MIP and P100. No correlation was found between the level of MIP and P100 and age and no differences were found between patients who failed and succeed extubation.
Conclusion
Measuring MIP and P100 during mechanical ventilation in paediatrics can give the clinician insight in respiratory muscle strength when extubation is to be expected. However, predicting extubation success is still to be wished for.