What question did this study set out to answer?

To evaluate the incidence of cardiac ischemia during weaning from mechanical ventilation and assess its association with weaning failure.

June 1, 1996CHEST JournalOpen Access

Cardiac Ischemia During Weaning From Mechanical Ventilation

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Why the study?

Does weaning from mechanical ventilation induce cardiac ischemia and affect weaning success in medical/cardiac ICU patients?

Population

93 patients in medical/cardiac ICUs before and during weaning from mechanical ventilation, mean age 66.5 +/…

Comparison

Weaning from mechanical ventilation vs Before weaning from mechanical ventilation

Design

Cohort

Follow-up

During weaning from mechanical ventilation

Authors

WCWissam ChatilaTemple University SASalim AniBridgeport Hospital DGDenise GuaglianoneBridgeport Hospital

Discussion

Member takes

Implication

Cardiac ischemia during weaning may raise failure risk in coronary disease patients; leaves open whether monitoring or cardioprotection improves ICU weaning success.

Key Points

To evaluate the incidence of cardiac ischemia during weaning from mechanical ventilation and assess its association with weaning failure.
Prospective observational study evaluating 93 medical and cardiac intensive care unit patients (mean age 66.5 ± 15.0 years; 49 with coronary artery disease) undergoing ventilator weaning.
Assessed electrocardiographic ST segments, rate-pressure product, respiratory rate to tidal volume ratio, and pulse oximetry before and during weaning trials.
Electrocardiographic ischemia occurred during weaning in 6 of 93 patients (6.4%), with 5 having prior coronary artery disease and 4 experiencing weaning failure.
Rate-pressure product across all patients increased significantly during weaning from 12.0 ± 3.1 to 13.4 ± 4.0 mm Hg·bpm·10³ (p < 0.01), and reduced oxygenation was strongly associated with weaning failure (RR = 3.9; 95% CI, 1.7 to 9.0).
Cardiac ischemia (RR = 1.8; 95% CI, 1.0 to 3.4) and increased respiratory rate to tidal volume ratio (RR = 1.7; 95% CI, 0.9 to 3.4) showed trends toward increasing the risk of weaning failure.

Structured PICO

Does weaning from mechanical ventilation induce cardiac ischemia and affect weaning success in medical/cardiac ICU patients?

Population

93 patients in medical/cardiac ICUs before and during weaning from mechanical ventilation, mean age 66.5 +/- 15.0 years, mean APACHE II score 16.0 +/- 6.9, mean duration of mechanical ventilation 5.2 +/- 8.6 days. 49 patients had coronary artery disease (CAD).

Intervention

Weaning from mechanical ventilation

Comparator

Before weaning from mechanical ventilation (baseline)

Outcome

ECG evidence of ischemia (ST segments), heart rate-systolic BP product (RPP), respiratory rate to tidal volume ratio (RVR), and pulse oximetry saturationssurrogate

Cardiac ischemia during weaning from mechanical ventilation is infrequent overall (6.4%) but may contribute to weaning failure, particularly in patients with underlying coronary artery disease.

Cite This Study

Chatila et al. (1996) studied this question.

synapsesocial.com/papers/6a89174358d99da5144d3282 https://doi.org/10.1378/chest.109.6.1577

Topics

Women and heart disease

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Implication

Cardiac ischemia during weaning may raise failure risk in coronary disease patients; leaves open whether monitoring or cardioprotection improves ICU weaning success.

Cardiac Ischemia During Weaning From Mechanical Ventilation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Cardiac Ischemia During Weaning From Mechanical Ventilation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider