Article ; Online: Effects of the First Spontaneous Breathing Trial in Children With Tracheostomy and Long-Term Mechanical Ventilation.
2023 Volume 68, Issue 10, Page(s) 1385–1392
Abstract: 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 ... ...
Abstract | 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 CO 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. |
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MeSH term(s) | Humans ; Male ; Child ; Infant ; Female ; Respiration, Artificial/methods ; Tracheostomy ; Ventilator Weaning/methods ; Respiration ; Respiratory Rate |
Language | English |
Publishing date | 2023-06-13 |
Publishing country | United States |
Document type | Observational Study ; Journal Article |
ZDB-ID | 603252-7 |
ISSN | 1943-3654 ; 0098-9142 ; 0020-1324 |
ISSN (online) | 1943-3654 |
ISSN | 0098-9142 ; 0020-1324 |
DOI | 10.4187/respcare.10544 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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