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Thursday, 11/19/2009
British Journal of Anaesthesia publishes our pioneering work on respiratory mechanics in patients admitted to ICU
The forced oscillation technique (FOT) is a useful and noninvasive technique that can be used to monitor respiratory mechanics during withdrawal of mechanical ventilation in intubated patients
The article Respiratory Impedance during weaning from mechanical ventilation in a mixed population of critically ill patients is the first job that tests a noninvasive technique, the Forced Oscillation Technique (FOT) to measure resistance and reactance of the lungs of outpatients admitted to ICUs who start weaning or withdrawal of mechanical ventilation.
These two parameters of respiratory mechanics have been assumed as key in the pathophysiology of weaning failure in previous works (Tobin MJ, N Engl J Med 2001; Jubran A, Tobin MJ, Am J Respir Crit Care Med 1997) in which invasive techniques were used, esophageal balloon driven by a catheter, for measuring resistance and reactance and generically concluded that these parameters were altered in the failure of weaning. However, these studies were conducted in patients with COPD and there were no studies in a heterogeneous sample of ventilated patients.
Now, the study led by Jacob Sellarés, promoted by the research group IAMR and conducted in collaboration with the Unit of Biophysics, Faculty of Medicine, University of Barcelona, shows that in a heterogeneous population of 29 patients, the parameters of respiratory mechanics, resistance and reactance do not vary significantly between patients with success or failure of weaning. Therefore, the widespread use of these parameters may not extend in the general population of patients who initiate weaning. Thus, the authors suggest the use of this technique in the early identification of reversible causes of weaning failure, where deterioration of respiratory mechanics is evident. Importantly, this work has been selected by this journal for continuing medical education (CME).