1 Introduction
2 Materials and methods
2.1 Subjects
2.2 Measurement
2.3 Pattern of breathing and respiratory effort
2.4 Ultrasonographic measurements
2.5 Protocol
2.6 Statistics
3 Results
3.1 Patient characteristics
Variable | Study population (n = 14) |
---|---|
Age (years) | 64 ± 7 |
Male sex—n (%) | 13 (93%) |
Actual body weight (kg) | 92 ± 13 |
Ideal body weight (kg) | 71 ± 8 |
Body height (m) | 1.77 ± 0.09 |
BMI (Kg/m2) | 29.3 ± 4.0 |
SAPS II (points) | 37 ± 5 |
Admission from | |
Medical ward | 8 (57%) |
Emergency department | 5 (36%) |
Other ICU | 1 (7%) |
Onset of symptoms to hospital admission (days) | 6 [4; 9] |
Hospital admission to ICU admission (days) | 2 [1; 3] |
Non-invasive ventilation before ICU admission (n—%) | 8 (57%) |
Duration of controlled mechanical ventilation (days) | 18 [15; 20] |
Duration of PSV before the study day (days) | 6 [3; 9] |
Length of ICU stay (days) | 36 ± 5 |
ICU mortality | 1 (7%) |
3.2 Effects of pressure support ventilation changes
Variable | Pressure support level | p | ||
---|---|---|---|---|
PS 0 | PS 5 | PS 10 | ||
Mean arterial blood pressure (mmHg) | 90 ± 11 | 88 ± 11 | 89 ± 14 | 0.9364 |
Heart rate (bpm) | 93 ± 13 | 92 ± 12 | 87 ± 12 | 0.4143 |
End-expiratory transmural central venous pressure (mmHg) | 5 [− 1; 9] | 4 [− 1; 9] | 4 [0; 8] | 0.4056 |
Respiratory rate (bpm) | 25 ± 6 | 23 ± 5 | 19 ± 4°* | 0.0069 |
Tidal volume (mL) | 461 ± 58 | 495 ± 43 | 560 ± 104°* | 0.0032 |
Minute ventilation (L/min) | 11.6 ± 3.3 | 11.5 ± 2.7 | 10.7 ± 2.8 | 0.6569 |
End-expiratory esophageal pressure (cmH2O) | 12 [7; 13] | 10 [7; 12] | 8 [6; 12] | 0.1014 |
End-inspiratory esophageal pressure (cmH2O) | 0 [− 3; 3] | 3 [− 2; 4]* | 4 [1; 7]°* | < 0.0001 |
End-expiratory central venous pressure (cmH2O) | 14 [12; 19] | 14 [10; 16] | 12 [9; 15] | 0.2938 |
End-inspiratory central venous pressure (cmH2O) | 4 [− 1; 11] | 5 [1; 12] | 8 [3; 14]°* | 0.0001 |
End-expiratory diaphragm thickness (cm) | 0.22 ± 0.03 | 0.22 ± 0.03 | 0.22 ± 0.03 | > 0.9999 |
End-inspiratory diaphragm thickness (cm) | 0.28 ± 0.03 | 0.26 ± 0.03 | 0.23 ± 0.03* | 0.0079 |
P0.1 (cmH2O) | 3.0 ± 1.5 | 2.0 ± 1.4 | 1.6 ± 1.2* | 0.0418 |
Pmusc, index (cmH2O) | 9.6 ± 5.2 | 5.0 ± 3.6* | 2.8 ± 2.4* | 0.0026 |