| Title |
New insights into weaning from mechanical ventilation: left ventricular diastolic dysfunction is a key player
|
|---|---|
| Published in |
Intensive Care Medicine, October 2011
|
| DOI | 10.1007/s00134-011-2368-0 |
| Pubmed ID | |
| Authors |
John Papanikolaou, Demosthenes Makris, Theodosios Saranteas, Dimitrios Karakitsos, Elias Zintzaras, Andreas Karabinis, Georgia Kostopanagiotou, Epaminondas Zakynthinos |
| Abstract |
PURPOSE: To investigate the diagnostic performance of Doppler echocardiography (DE) in predicting the outcome of weaning from mechanical ventilation in patients without overt cardiac disease. METHODS: Fifty critical care noncardiac patients who fulfilled predetermined criteria for weaning underwent DE before and at the end of spontaneous breathing trial (pre-SBT/end-SBT, respectively). "Conventional" mitral inflow analysis and "advanced" DE parameters [tissue Doppler imaging (TDI)-derived mitral/tricuspid annular velocities and color M-mode Doppler velocity of propagation (V (p))] were used to assess left ventricular (LV) diastolic function/filling pressures. Weaning was considered successful if patients had been extubated after successful SBT and sustained spontaneous breathing for more than 48 h. RESULTS: Twenty-eight patients (56%) failed weaning: 23 patients failed SBT and 5 required reintubation within 48 h. Weaning failure was associated with the degree of LV diastolic dysfunction at pre-SBT (P = 0.01). Patients who failed weaning presented evidence of increased LV filling pressures at pre-SBT, by demonstrating increased E/E (m) and E/V (p) ratios compared with patients with successful outcome (P ≤ 0.004); pre-SBT values of lateral E/E (m) greater than 7.8 and E/V (p) greater than 1.51 predicted weaning failure with an area under the curve, sensitivity (%), and specificity (%) of 0.86, 79, and 100, and 0.74, 75, and 73, respectively. Lateral E/E (m) was the only factor independently associated with weaning failure before SBT; OR (95% CI) 5.62 (1.17-26.96), P = 0.03. CONCLUSIONS: Our findings suggest that LV diastolic dysfunction is significantly associated with weaning outcome in critically ill patients with preserved LV systolic function. An E/E (m) ratio greater than 7.8 may identify patients at high risk of weaning failure. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 3 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 67% |
| Practitioners (doctors, other healthcare professionals) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 162 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 2% |
| France | 2 | 1% |
| Brazil | 1 | <1% |
| South Africa | 1 | <1% |
| Netherlands | 1 | <1% |
| Iran, Islamic Republic of | 1 | <1% |
| Egypt | 1 | <1% |
| Spain | 1 | <1% |
| Belgium | 1 | <1% |
| Other | 0 | 0% |
| Unknown | 150 | 93% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 18 | 11% |
| Student > Postgraduate | 18 | 11% |
| Other | 17 | 10% |
| Student > Ph. D. Student | 15 | 9% |
| Professor | 15 | 9% |
| Other | 50 | 31% |
| Unknown | 29 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 112 | 69% |
| Nursing and Health Professions | 6 | 4% |
| Arts and Humanities | 2 | 1% |
| Social Sciences | 2 | 1% |
| Computer Science | 1 | <1% |
| Other | 4 | 2% |
| Unknown | 35 | 22% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 August 2017.
All research outputs
#7,166,280
of 22,653,392 outputs
Outputs from Intensive Care Medicine
#2,774
of 4,967 outputs
Outputs of similar age
#43,855
of 133,853 outputs
Outputs of similar age from Intensive Care Medicine
#8
of 18 outputs
Altmetric has tracked 22,653,392 research outputs across all sources so far. This one has received more attention than most of these and is in the 67th percentile.
So far Altmetric has tracked 4,967 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 26.5. This one is in the 43rd percentile – i.e., 43% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 133,853 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 66% of its contemporaries.
We're also able to compare this research output to 18 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 55% of its contemporaries.