Abstract
Weaning from mechanical ventilation is usually associated with an increase in oxygen consumption (VO2), which may stress the cardiovascular system. We studied relative changes in the cardiac index and oxygen extraction ratio (EO2) during successful weaning in patients after cardiac surgery (n = 52), cardiac transplantation (n = 17), or abdominal aortic surgery (n = 11). Cardiac index was determined by the thermodilution technique and arterial and mixed venous blood gases were obtained before and 30 min after the start of weaning through a T-piece. The cardiovascular changes were evaluated in 42 patients in whom VO2 (calculated by Fick’s equation) increased by more than 10 %. Cardiac index increased more after abdominal aortic surgery (from 3.27 ± 0.77 to 4.44 ± 0.58 l min–1 m–2, p < 0.01) than after cardiac surgery (from 2.53 ± 0.59 to 2.87 ± 0.46 l min–1 m–2, p < 0.01) or cardiac transplantation (from 2.99 ± 0.64 to 3.33 ± 0.74 l min–1 m–2, p < 0.05). EO2 remained stable in patients after aortic surgery (from 25.9 ± 7.1 to 25.2 ± 5.6 %, NS) but increased slightly after cardiac surgery (from 33.3 ± 6.1 to 37.3 ± 6.4 %, NS) and significantly after cardiac transplantation (from 25.8 ± 4.1 to 28.2 ± 4.0 %, p < 0.05). Hence the cardiovascular response to weaning from mechanical ventilation may vary according to the type of surgery.
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Received: 14 June 1999/Final revision received: 18 April 2000/Accepted: 26 April 2000
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De Backer, D., El Haddad, P., Preiser, JC. et al. Hemodynamic responses to successful weaning from mechanical ventilation after cardiovascular surgery. Intensive Care Med 26, 1201–1206 (2000). https://doi.org/10.1007/s001340051338
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DOI: https://doi.org/10.1007/s001340051338