Comparison of Energy Expenditure and Oxygen Consumption of Spontaneous Breathing Trial Conducted With and Without Automatic Tube Compensation

Alessandra Fabiane Lago, Elaine Cristina Goncalves, Elaine Caetano Silva, Mayra Goncalves Menegueti, Edson Antonio Nicolini, Maria Auxiliadora-Martins, Edson Zangiacomi Martinez, Ada Clarice Gastaldi, Anibal Basile-Filho

Abstract


Background: Weaning from mechanical ventilation is defined as the process of release of ventilatory support and how the evaluation of this phase is conducted in the spontaneous breathing trial (SBT). One of the most used modes of SBT is the continuous positive airway pressure (CPAP), which applies a continuous positive pressure in both inspiration and expiration. However, together with the mechanical ventilation modes, the automatic tube compensation (ATC) can be used, which compensates the resistance imposed by the endotracheal tube. The objective of this study was to compare oxygen consumption (VO2) and energy expenditure (EE) during SBT conducted with and without ATC.

Methods: The study was prospective, randomized and crossover. Forty mechanically ventilated patients were admitted to an intensive care unit of a university tertiary hospital. The participants were randomly allocated in group 1, in which SBT was initiated with CPAP and ATC, followed by CPAP without ATC or in group 2, in which SBT was initiated with CPAP without ATC, followed by CPAP with ATC. Indirect calorimetry helped to measure VO2 and EE during SBT.

Results: The differences between VO2 and EE obtained during SBT with ATC and without ATC were -1.6 mL/kg/min (95% CI: -4.36 - 1.07) and 5.4 kcal/day (95% CI: -21.67 - 10.79), respectively.

Conclusions: We concluded that VO2 and EE obtained during SBT with and without ATC were not different.




J Clin Med Res. 2015;7(9):700-705
doi: http://dx.doi.org/10.14740/jocmr2250w


Keywords


Indirect calorimetry; Ventilator weaning; Respiratory insufficiency; Artificial respiration; Intensive care units

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