https://doi.org/10.4081/scenario.2020.429

Parametri clinici, strumentali e indici per l’ingresso del paziente adulto nel trial di svezzamento da ventilazione meccanica: revisione di letteratura

Vol. 37 No. 2 (2020): SCENARIO 2 2020
Submitted: 18 July 2020
Accepted: 18 July 2020
Published: 18 July 2020
Abstract Views: 953
PDF (Italiano): 456
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Sara Ciuffi
webmaster@aniarti.it
Pasquale Iozzo
Alberto Lucchini
Monica Trevisan
Guya Piemonte
Matteo Manici
Irene Comisso
Gian Domenico Giusti
Filippo Marchese
Elisa Mattiussi
Stefano Elli
Cristian Fusi
Enrico Bulleri
Guglielmo Imbriacco
Alessandra Negro
Laura Rasero
Stefano Bambi
Il weaning è un processo decisionale dinamico e collaborativo che copre l’intero processo di liberazione del paziente dal supporto ventilatorio meccanico e dal device endotracheale. I parametri clinici, strumentali e gli indici sono elementi che permettono di valutare la capacità di far fronte del paziente allo svezzamento dalla ventilazione meccanica e dunque il successo o il fallimento del processo stesso. L’obiettivo della presente revisione di letteratura è quello di rilevare il grado di efficacia di questi parametri e degli indici attualmente disponibili in termini di funzionalità predittive, e quindi di utilità nella pratica clinica.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
BOLES JM1, BION J, CONNORS A, HERRIDGE M, MARSH B, MELOT C, PEARL R, SILVERMAN H, STANCHINA M, VIEILLARD-BARON A, WELTE T. Weaning from mechanical ventilation.Eur Respir J. 2007 May;29(5):1033-56.
BROCHARD L. Pressure support is the preferred weaning method. 5th International Consensus Conference in Intensive Care Medicine: Weaning from Mechanical Ventilation, 2005. Hosted by ERS, ATS, ESICM, SCCM and SRLF.
ESTEBAN A, ALIA I, IBANEZ J, BENITO S, TOBIN MJ. Modes of mechanical ventilation and weaning. A national survey of Spanish hospitals. The Spanish Lung Failure Collaborative Group; Chest. 1994 Oct;106(4):1188-93.
ESTEBAN A, ANZUETO A, FRUTOS F, ALÃA I, BROCHARD L, STEWART TE, BENITO S, EPSTEIN SK, APEZTEGUÃA C, NIGHTINGALE P, ARROLIGA AC, TOBIN MJ; MECHANICAL VENTILATION INTERNATIONAL STUDY GROUP. MECHANICAL VENTILATION INTERNATIONAL STUDY GROUP.Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA. 2002 Jan 16;287(3):345-55.
TOBIN MJ. Mechanical ventilation. N Engl J Med 1994; 330:1056-1061
BURNS SM. AACN Protocols for practice: Care of Mechanically Ventilated Patients, 2007. 2nd edition. Jones and Bartlett Publishers.
THELAN L. Critical care nursing, 1998. Diagnosis and management.
KOLLEF MH, BEDIENT TJ. Weaning from Mechanical Ventilation, 2011. The Washington Manual of Critical Care; 101-04.
NATALINI G. Svezzamento dalla ventilazione meccanica: come fare il trial di respiro spontaneo, 2017. Ultima consultazione 2592019. Disponibile all’indirizzo http://www.ventilab.org.
JACKSON CD, MUTHAIAH P, RYLAND P, ROY T. What are the advantages of spontaneous breathing trial (SBT) to wean patients from mechanical ventilation? April 2019. Ultima consultazione 2792019. Disponibile all’indirizzo https:medscape.com
CHITTAWATANARAT K, ORRAPIN S, ORRAPIN S. An open label randomized control trial between low pressure support and T-piece method for discontinuation from mechanical ventilation and extubation in general surgical intensive care units. Crit Care. 2015; 19(Suppl 1): P268.
BURNS KEA, SOLIMAN I, ADHIKARI NKJ, ZWEIN A, WONG JTY, GOMEZ-BUILES C, PELLEGRINI JA, CHEN L, RITTAYAMAI N, SKLAR M, BROCHARD LJ, FRIEDRICH JO.Trials directly comparing alternative spontaneous breathing trial techniques: a systematic review and meta-analysis. Crit Care. 2017 Jun 1;21(1):127. doi: 10.1186/s13054-017-1698-x.
LEUNG P, JUBRAN A, TOBIN M. Comparison of assisted ventilator modes on triggering, patient effort and dyspnea. Am J Respir Crit Care Med. 1997 Jun;155(6):1940-8.
LEMAIRE F, TEBOUL JL, CINOTTI L, GIOTTO G, ABROUK F, STEG G, MACQUIN-MAVIER I, ZAPOL WM. Acute left ventricular dysfunction during unsuccessful weaning from mechanical ventilation. Anesthesiology. 1988 Aug;69(2):171-9.
BEDNARIK J, LUCAS Z, VONDRACEK P. Critical illness polyneuropathy: the electrophysiological components of a complex entity. Intensive Care Med. 2003 Sep;29(9):1505-14. Epub 2003 Jul 17.
MACINTYRE NR, COOK DJ, ELY EW JR, EPSTEIN SK, FINK JB, HEFFNER JE, HESS D, HUBMAYER RD, SCHEINHORN DJ; AMERICAN COLLEGE OF CHEST PHYSICIANS; AMERICAN ASSOCIATION FOR RESPIRATORY CARE; AMERICAN COLLEGE OF CRITICAL CARE MEDICINE.Evidence-based guidelines for weaning and discontinuing ventilatory support: a collective task force facilitated by the American College of Chest Physicians; the American Association for Respiratory Care; and the American College of Critical Care Medicine. Chest. 2001 Dec;120(6 Suppl):375S-95S.
MEADE M, GUYATT G, COOK D, GRIFFITH L, SINUFF T, KERGL C, MANCEBO J, ESTEBAN A, EPSTEIN S.Predicting success in weaning from mechanical ventilation. Chest. 2001 Dec;120(6 Suppl):400S-24S.
YANG KL, TOBIN MJ. A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation. N Engl J Med. 1991 May 23;324(21):1445-50
DELISLE S, FRANCOEUR M, ALBERT M, OUELLET P, BELLEMARE P, ARSENAULT P. Preliminary evaluation of a new index to predict the outcome of a spontaneous breathing trial. Respir Care. 2011 Oct;56(10):1500-5. doi: 10.4187/respcare.00768. Epub 2011 Feb 9
DE JONGHE B, SHARSHAR T, LEFAUCHEUR JP, AUTHIER FJ, DURAND-ZALESKI I, BOUSSARSAR M, CERF C, RENAUD E, MESRATI F, CARLET J, RAPHAËL JC, OUTIN H, BASTUJI-GARIN S; GROUPE DE RÉFLEXION ET D'ETUDE DES NEUROMYOPATHIES EN RÉANIMATION. Paresis Acquired in the Intensive Care Unit- a prospective multicenter study. JAMA. 2002 Dec 11;288(22):2859-67.
COTTEREAU G, DRES M, AVENEL A, FICHET J, JACOBS FM, PRAT D, HAMZAOUI O, RICHARD C, ANTONELLO M, SZTRYMF B. Handgrip strength predicts difficult weaning but not failure extubation failure in mechanically ventilated subjects. Respir Care. 2015 Aug;60(8):1097-104. doi: 10.4187/respcare.03604. Epub 2015 Mar 10.
VERONA C, HACKENHAAR FS, TEIXEIRA C, MEDEIROS TM, ALABARSE PV, SALOMON TB, SHÃœLLER ÃK, MACCARI JG, CONDESSA RL, OLIVEIRA RP, RIOS VIEIRA SR, BENFATO MS. Blood markers of oxidative stress predict weaning failure from mechanical ventilation. J Cell Mol Med. 2015 Jun;19(6):1253-61. doi: 10.1111/jcmm.12475. Epub 2015 Apr 9.
HEMANS S, ANOUK AGTEN, TESTELMANS DRIES, DECRAMER MARC, GHISLAINE GAYAN-RAMIREZ. Increased duration of mechanical ventilation associated with decreased diaphragmatic force: a prospective observational study. Crit Care. 2010; 14(4): R127.
LI C, LI X, HAN H, CUI H, WANG G, WANG Z. Diaphragmatic ultrasonography for predicting ventilator weaning A meta-analysis. Medicine (Baltimore). 2018 Jun;97(22):e10968. doi: 10.1097/MD.0000000000010968.
PIROMPANICH P, ROMSAIYUT S. Use of diaphragm thickening fraction combined with rapid shallow breathing index for predicting success of weaning from mechanical ventilator in medical patients. J Intensive Care. 2018 Feb 2;6:6. doi: 10.1186/s40560-018-0277-9. eCollection 2018.
FERRARI G, DE FILIPPI G, ELIA F, PANERO F, VOLPICELLI G, APRÀ F. Diaphragm ultrasound as a new index of discontinuation from mechanical ventilation. Crit Ultrasound J. 2014; 6(1): 8.
SAMANTA S, SINGH RK, BARONIA AK, PODDAR B, AZIM A, GURJAR M. Diaphragm thickening fraction to predict weaning—a prospective exploratory study. J Intensive Care. 2017; 5: 62.
SOLIMAN SB, RAGAB F, SOLIMAN RA, GABER A, KAMAL A. Chest Ultrasound in predication of weaning failure. Open Access Maced J Med Sci. 2019 Apr 15; 7(7): 1143–1147.
ABDELWAHED WM , ABD ELGHAFAR MS , AMR YM , ALSHERIF SEI , ELTOMEY MA.Prospective study: Diaphragmatic thickness as a predictor index for weaning from mechanical ventilation. J Crit Care. 2019 Aug;52:10-15. doi: 10.1016/j.jcrc.2019.03.006. Epub 2019 Mar 15.
TENZA-LOZANO E, LLAMAS-ALVAREZ A, JAIMEZ-NAVARRO E, FERNÃNDEZ-SÃNCHEZ J.Lung and diaphragm ultrasound as predictors of success in weaning from mechanical ventilation. Crit Ultrasound J. 2018; 10: 12.
NEMER SN, BARBAS CS, CALDEIRA JB, CÃRIAS TC, SANTOS RG, ALMEIDA LC, AZEREDO LM, NOÉ RA, GUIMARÃES BS, SOUZA PC.A new integrative weaning index of discontinuation from mechanical ventilation. Crit Care. 2009; 13(5): R152.
BONIATTI VM, BONIATTI MM, ANDRADE CF, ZIGIOTTO CC, KAMINSKI P, GOMES SP, LIPPERT R, MIGUEL DC, FELIX EA. The modified integrative weaning index as a predictor of extubation failure. Respir Care. 2014 Jul;59(7):1042-7. doi: 10.4187/respcare.02652. Epub 2013 Nov 26.
MABROUK A ,MANSOUR O,AMIN A, ALHABASHY M, ALASDOUDY A. Evaluation of some predictors for successful weaning from mechanical ventilation. European Respiratory Journal 2015 46: PA2188; DOI: 10.1183/13993003.congress-2015.PA2188
PRAVEEN J, ANITHA N, SAUMY J. Comparison of five weaning indices in predicting successful weaning from mechanical ventilation.Indian Journal of Respiratory Care; 2013;2:299-306
ABBAS A , EMBARAK S , WALAA M .Role of diaphragmatic rapid shallow breathing index in predicting weaning outcome in patients with acute exacerbation of COPD. Int J Chron Obstruct Pulmon Dis. 2018 May 21;13:1655-1661.
SPADARO S, GRASSO S, MAURI T, DALLA CORTE F, ALVISI V, RAGAZZI R, CRICCA V, BIONDI G, DI MUSSI R, MARANGONI E, VOLTA CA. Can diaphragmatic ultrasonography performed during the T-tube trial predict weaning failure? The role of diaphragmatic rapid shallow breathing index. Crit Care. 2016 Sep 28;20(1):305.
BURNS SM. Weaning Process, 2015. Critical Care Medicine.
BURNS SM, RYAN B, BURNS JE. The weaning continuum use of acute physiology and chronic health evaluation III Burns Wean Assessment Program, Therapeutic Intervention Scoring System, and Wean Index scores to establish stages of weaning. Crit Care Med. 2000 Jul;28(7):2259-67.
BURNS SM, FISHER C, EARVEN TRIBBLE SS, LEWIS R, MERREL P, CONAWAY MR, BLECK TP.Multifactor clinical score and outcome of mechanical ventilation weaning trials: Burns Wean Assessment Program. Am J Crit Care. 2010 Sep;19(5):431-9. doi: 10.4037/ajcc2010273.
SOLSONA F, DIAZ Y, VAZQUEZ A, PILAR GRACIA M, ZAPATERO A, MARRUGAT J. A pilot study of a new test to predict extubation failure. Crit Care. 2009;13(2):R56. doi: 10.1186/cc7783. Epub 2009 Apr 14
ROSE L, PRESNEILL JJ. Clinical prediction of weaning and extubation in Australian and New Zealand intensive care units. Anaesth Intensive Care. 2011 Jul;39(4):623-9.
SANTOS LIMA EJ. Respiratory rate as a predictor of weaning failure from mechanical ventilation. Braz J Anesthesiol. 2013 Jan-Feb;63(1):1-6. doi: 10.1016/S0034-7094(13)70194-6.
BURNS S, FISHER C, TRIBBLE S, LEWIS R, MERREL P, R. CONAWAY M, BLECK T. The relationship of 26 clinical factors to weaning outcomes. Am J Crit Care. 2012 Jan;21(1):52-8; quiz 59. doi: 10.4037/ajcc2012425.
DI NINO E, GARTMAN EJ, SETHI JM, MCCOOL FD. Diaphragm ultrasound as a predictor of successful extubation from mechanical ventilation. Thorax. 2014 May;69(5):423-7. doi: 10.1136/thoraxjnl-2013-204111. Epub 2013 Dec 23.
TEIXEIRA SN, OSAKU EF, COSTA CR, TOCCOLINI BF, COSTA NL, CÂNDIA MF, LEITE MA, JORGE AC, DUARTE PA. Comparison of Proportional Assist Ventilation Plus, T-Tube Ventilation, and Pressure Support Ventilation as Spontaneous Breathing Trials for Extubation: A Randomized Study. Respir Care. 2015 Nov;60(11):1527-35. doi: 10.4187/respcare.03915. Epub 2015 Jul 7.
FERNANDEZ MM, GONZÃLEZ-CASTRO A, MAGRET M, BOUZA MT, IBAÑEZ M, GARCÃA C, BALERDI B, MAS A, ARAUZO V, AÑÓN JM1, RUIZ F, FERRERES J, TOMÃS R, ALABERT M, TIZÓN AI, ALTABA S, LLAMAS N, FERNANDEZ R. Reconnection to mechanical ventilation for 1 h after a successful spontaneous breathing trial reduces reintubation in critically ill patients: a multicenter randomized controlled trial. Intensive Care Med. 2017 Nov;43(11):1660-1667. doi: 10.1007/s00134-017-4911-0. Epub 2017 Sep 22.
BANERJEEE A, MEHROTRA G. Comparison of Lung Ultrasound-based Weaning Indices with Rapid Shallow Breathing Index: Are They Helpful? Indian J Crit Care Med. 2018 Jun;22(6):435-440. doi: 10.4103/ijccm.IJCCM_331_17.
THEERAWIT P, EKSOMBATCHAI D, SUTHERASAN Y, SUWATANAPONGCHED T, KIATBOONSRI C, KIATBOONSRI S. Diaphragmatic parameters by ultrasonography for predicting weaning outcomes. BMC Pulm Med. 2018 Nov 23;18(1):175. doi: 10.1186/s12890-018-0739-9.
PALKAR A, NARASIMHAN M, GREENBERG H, SINGH K, KOENIG S , MAYO P, GOTTESMAN E.Diaphragm Excursion-Time Index: A New Parameter Using Ultrasonography to Predict Extubation Outcome. Chest. 2018 May;153(5):1213-1220. doi: 10.1016/j.chest.2018.01.007. Epub 2018 Jan 17.
WU TJ, SHIAO JS, YU HL, LAI RS. An Integrative Index for Predicting Extubation Outcomes After Successful Completion of a Spontaneous Breathing Trial in an Adult Medical Intensive Care Unit. J Intensive Care Med. 2019 Aug;34(8):640-645. doi: 10.1177/0885066617706688. Epub 2017 Apr 26.
GHIASI F, GOHARI MOGHADAM K, ALIKIAII B, SADRZADEH S, FARAJZADEGAN Z. The prognostic value of rapid shallow breathing index and physiologic dead space for weaning success in intensive care unit patients under mechanical ventilation. J Res Med Sci. 2019 Feb 25;24:16. doi: 10.4103/jrms.JRMS_349_18. eCollection 2019.

Supporting Agencies

How to Cite

Ciuffi, S., Iozzo, P., Lucchini, A., Trevisan, M., Piemonte, G., Manici, M., Comisso, I., Giusti, G. D., Marchese, F., Mattiussi, E., Elli, S., Fusi, C., Bulleri, E., Imbriacco, G., Negro, A., Rasero, L., & Bambi, S. (2020). Parametri clinici, strumentali e indici per l’ingresso del paziente adulto nel trial di svezzamento da ventilazione meccanica: revisione di letteratura. Scenario® - Il Nursing Nella Sopravvivenza, 37(2), 16–30. https://doi.org/10.4081/scenario.2020.429

Aniarti has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.