• Department of Intensive Care Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210009, P. R. China;
DONG Danjiang, Email: dongdanjiang@sina.com
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Objective To compare the predictive values of dynamic energy expenditure (EE) monitoring and the traditional method (rapid shallow breath index) for weaning in patient who is suitable for weaning from mechanical ventilation and accepts sequentially reduced support of ventilator.Methods This study included a total of 93 patients who were admitted to the Department of Intensive Care Medicine in 2018 to 2019, and were eligible for weaning from mechanical ventilation. The energy expenditure monitoring device of GE ventilator (CARESCAPE R860) was used to record the patient's change rate of EE [δEE(%), T1 (PSV 20/5), T2 (PSV 15/5), T3 (PSV 10-5/5), T4 (PSV 5/5)] while the ventilation support was declined. The differences in δEE were compared between the two groups of patients who were successful weaned (a successful group S) or failed (a failed group) at different phases. The receiver operator characteristic (ROC) curve was used to analyze the predictive value of δEE to the success rate of weaning.Result A total of 36 patients failed weaning procedure. There was no significant difference in the basic status and disease type between the successful group and the failed group. There was no difference in δEE1 between T1-T2 phases [(5.67±2.31)% vs. (6.40±1.90)%, P>0.05], but significant difference in δEE between T2-T3 and T3-T4 phases [δEE2: (11.35±5.39)% vs. (14.21±6.33)%, P<0.05; δEE3: (8.39±3.90)% vs. (17.32±9.07)%, P<0.05]. The area under the ROC curve predicted by δEE2 and δEE3 for the patient's weaning results was higher than rapid shallow breath index (0.83 and 0.75 vs. 0.64, P<0.05).Conclusion Dynamic energy expenditure monitoring can effectively evaluate and predict the success rate of weaning from mechanical ventilation, and can be applied to the clinical treatment process.

Citation: QIAN Yajun, LIU Yang, HAO Yingying, CHEN Ming, GU Qin, DONG Danjiang. Clinical study on the predictive value of dynamic energy expenditure monitoring to guide the weaning from mechanical ventilation. Chinese Journal of Respiratory and Critical Care Medicine, 2021, 20(5): 325-329. doi: 10.7507/1671-6205.202004041 Copy

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