Abstract
This chapter focuses on patients with acute lung injury (ALI) and/or acute respir-atory distress syndrome (ARDS). Patients with these disorders usually receive mechanical ventilation for several days or weeks, and every critical care physician can recall a patient with ARDS who experienced difficulty when attempting to re-sume spontaneous ventilation. Yet, research that specifically focuses on the prob-lems of discontinuing ventilator support in patients with ALI and/or ARDS does not exist. In reporting research on weaning, investigators have not indicated that patients with ARDS exhibit unique behavior that makes them different from other patients being weaned from mechanical ventilation. Accordingly, this review is based on data obtained in patients recovering from acute respiratory failure due to a variety of causes and not exclusively from ARDS.
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References
Tobin, MJ, Alex CG (1994) Discontinuation of mechanical ventilation. In: Tobin MJ (ed) Principles and Practice of Mechanical Ventilation. McGraw Hill, New York, pp 1177 – 1206
Lessard MR, Brochard LJ (1996) Weaning from ventilatory support. Clinics Chest Med 17: 475 – 489
Rodriguez—Roisin R (1994) Effect of mechanical ventilation on gas exchange. In: Tobin MJ (ed) Principles of Mechanical Ventilation. McGraw Hill, New York, pp 673 – 693
Criner GJ, Isaac L (1994) Psychological problems in the ventilator—dependent patient. In: Tobin MJ (ed) Principles and Practice of Mechanical Ventilation. McGraw Hill, New York, pp 1163 – 1175
Tobin MJ, Perez W, Guenther SM, et al (1986) The pattern of breathing during successful and unsuccessful trials of weaning from mechanical ventilation. Am Rev Respir Dis 134: 1111 – 1118
Sassoon CSH, Mahutte CK (1993) Airway occlusion pressure and breathing pattern as predictors of weaning outcome. Am Rev Respir Dis 148: 860 – 866
Decramer M, de Bock V, Dom R (1996) Functional and histologic picture of steroid—induced myopathy in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 153: 1958 – 1964
Marini JJ, Smith TC, Lamb V (1986) Estimation of inspiratory muscle strength in mechanically ventilated patients: The measurement of maximal inspiratory pressure. J Crit Care 1: 32 – 38
Multz AS, Aldrich TK, Prezant DJ, Karpel JP, Hendler JM (1990) Maximal inspiratory pressure is not a reliable test of inspiratory muscle strength in mechanically ventilated patients. Am Rev Respir Dis 142: 529 – 532
Aldrich TK, Spiro P (1995) Maximal inspiratory pressure: Does reproducibility indicate full effort? Thorax 50: 40 – 43
Sahn SA, Lashminarayan S (1973) Bedside criteria for discontinuation of mechanical ventilation. Chest 63: 1002 – 1005
Yang KL, Tobin MJ (1991) A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med 324: 1445 – 1450
Tobin, MJ, Jubran A (1994) Pathophysiology of failure to wean from mechanical ventilation. Schweiz Med Wochenschr 124: 2139 – 2145
Tobin MJ (1988) Respiratory muscles in disease. Clinics Chest Med 9: 263 – 286
Jubran A, Tobin MJ (1997) Pathophysiological basis of acute respiratory distress in patients who fail a trial of weaning from mechanical ventilation. Am J Respir Crit Care Med 155: 906 – 915
Jubran A, Tobin MJ (1997) Passive mechanics of lung and chest wall in patients who failed or succeeded in trials of weaning. Am J Respir Crit Care Med 155: 916 – 921
Ramsdell JW, Nachtwey FS, Moser KM (1982) Bronchial hyperactivity in chronic obstructive bronchitis. Am Rev Respir Dis 126: 829 – 832
Woolcock A J, Vincent NJ, Macklem PT (1969) Frequency dependence of compliance as a test for obstruction in the small airways. J Clin Invest 48: 1097 – 1106
NHLBI Workshop Summary (1990) Respiratory muscle fatigue: Report of the respiratory muscle fatigue workshop group. Am Rev Respir Dis 42: 474 – 480
Cohen C, Zagelbaum G, Gross D, Roussos C, Macklem PT (1982) Clinical manifestations of inspiratory muscle fatigue. Am J Med 73: 308 – 316
Goldstone JC, Green M, Moxham J (1994) Maximum relaxation rate of the diaphragm during weaning from mechanical ventilation. Thorax 49: 54 – 60
Esau SA, Bye PTP, Pardy RL (1983) Change in rate of relaxation of sniffs with diaphragmatic fatigue in humans. J Appi Physiol 55: 731 – 735
Swartz MA, Marino PL (1985) Diaphragmatic strength during weaning from mechanical ventilation. Chest 85: 736 – 739
Le Bourdelles G, Viires N, Boczkowski J, et al (1994) Effects of mechanical ventilation on diaphragmatic contractile properties in rats. Am J Respir Crit Care Med 149: 1539 – 1544
Anzueto A, Peters JT, Tobin MJ, et al (1997) Effects of prolonged mechanical ventilation on diaphragmatic function in healthy adults. Crit Care Med (In press)
Bellemare F, Grassino A (1982) Effect of pressure and timing of contraction of the human diaphragm fatigue. J Appi Physiol 53: 1190 – 1195
McCool FD, McCann DR, Leith DE, Hoppin FG (1986) Pressure–flow effects on endurance of inspiratory muscles. J Appi Physiol 60: 299 – 301
Clanton TL, Dixon GF, Drake J, Gadek JE (1985) Effects of breathing pattern on inspiratory muscle endurance in humans. J Appi Physiol 59: 1834 – 1841
Babcock MA, Pegelow DR, McClaran SR, Suman OE, Dempsey JA (1995) Contribution of diaphragmatic power output to exercise—induced diaphragm fatigue. J Appi Physiol 78: 1710 – 1719
Leblanc P, Summers E, Inman MD, Jones NL, Campbell EJM, Killian KJ (1988) Inspiratory muscles during exercise: A problem of supply and demand. J Appi Physiol 64: 2482 – 2489
Tobin MJ, Guenther SM, Perez W, et al (1987) Konno—Mead analysis of ribcage–abdominal motion during successful and unsuccessful trials of weaning from mechanical ventilation. Am Rev Respir Dis 135: 1320 – 1328
Goldman MD, Grimby G, Mead J (1976) Mechanical work of breathing derived from rib cage and abdominal V—P partitioning. J Appi Physiol 41: 752 – 763
Roussos, C, Moxham J, Bellemare F (1995) Respiratory muscle fatigue. In: Roussos C (ed) The Thorax (2nd ed) Marcel Dekker, New York, pp 1405 – 1461
Bellemare F, Bigland—Ritchie B (1987) Central components of diaphragmatic fatigue assessed by phrenic nerve stimulation. J Appi Physiol 62: 1307 – 1316
Laghi F, D’Alfonso N, Tobin MJ (1995) Pattern of recovery from diaphragmatic fatigue over 24 hours. J Appi Physiol 79: 539 – 546
Banzett, RB, Lansing RW, Reid MB, Adams L, Brown R (1989) “Air hunger” arising from increased PC02 in mechanically ventilated quadriplegics. Resp Physiol 76:53–68
Dunn WF, Nelson SB, Hubmayr RD (1991) The control of breathing during weaning from mechanical ventilation. Chest 100: 754 – 761
Mador MJ, Tobin MJ (1992) The effect of inspiratory muscle fatigue on breathing pattern and ventilatory response to C02. J Physiol (Lond) 455: 17 – 31
Yan, S, Sliwinski P, Gauthier AP, Lichros I, Zakynthinois S, Macklem PT (1993) Effect of global inspiratory muscle fatigue on ventilatory and respiratory muscle responses to C02. J Appi Physiol 75: 1371 – 1377
Bellemare F, Bigland—Ritchie B, Woods JJ (1986) Contractile properties of the human diaphragm in vivo. J Appi Physiol 61: 1153 – 1161
Ferguson GT (1994) Use of twitch pressure to assess diaphragmatic function and central drive. J Appi Physiol 77: 1705 – 1715
Similowski T, Yan S, Gauthier AP, Macklem PT, Bellemare F (1991) Contractile properties of the human diaphragm during chronic hyperinflation. N Engl J Med 325: 917 – 923
Similowski T, Fleury B, Launois S, Cathala HP, Bouche P, Derenne JP (1989) Cervical magnetic stimulation: A new painless method of bilateral phrenic nerve stimulation in conscious humans. J Appi Physiol 67: 13311 – 1318
Laghi F, Harrison MJ, Tobin MJ (1996) Comparison of magnetic and electrical phrenic nerve stimulation in assessment of diaphragmatic contractility. J Appi Physiol 80: 1731 – 1742
Stroetz RW, Hubmayr RD (1995) Tidal volume maintenance during weaning with pressure support. Am J Respir Crit Care Med 152: 1034 – 1040
Sassoon CSH (1994) Intermittent mandatory ventilation. In: Tobin MJ (ed) Principles and Practice of Mechanical Ventilation. McGraw Hill, New York, pp 221 – 237
Brochard L (1994) Pressure support ventilation. In: Tobin MJ (ed) Principles and Practice of Mechanical Ventilation. McGraw Hill, New York, pp 239 – 257
Esteban A, Frutos F, Tobin MJ, et al (1995) A comparison of four methods of weaning patients from mechanical ventilation. N Engl J Med 332: 345 – 350
Brochard L, Rauss A, Benito S, et al (1994) Comparison of three methods of gradual withdrawal from ventilatory support during weaning from mechanical ventilation. Am J Respir Crit Care Med 150: 896 – 903
Ely EW, Baker AM, Dunagan DP, et al (1996) Effect of the duration of mechanical ventilation of identifying patients capable of breathing spontaneously. N Engl J Med 335: 1864 – 1869
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Tobin, M.J., Jubran, A., Laghi, F. (1998). Respiratory Muscle Fatigue and Weaning. In: Marini, J.J., Evans, T.W. (eds) Acute Lung Injury. Update in Intensive Care and Emergency Medicine, vol 30. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60733-2_18
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DOI: https://doi.org/10.1007/978-3-642-60733-2_18
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