Correlation of the oxygen cost of breathing and length of weaning from mechanical ventilation

Abstract
We studied 20 patients (ages 43 to 84 yr), whose forced vital capacity, peak negative inspiratory pressure and alveolar-arterial gradient indicated that they were unlikely to be withdrawn rapidly from mechanical ventilation. Their mean oxygen consumption (Vo2) during controlled ventilation (CV) was 292 ± 21 (SEM) ml/min. During spontaneous ventilation (SV) through endotracheal tube and ventilator circuit, the Vo2 rose significantly (p < .001) to 323 ± 20 ml/min. The oxygen cost of breathing (OCB) (the difference in Vo2 between CV and SV) and the OCB as a fraction of the oxygen consumed during SV (OCB/Vo2 SV) both correlated significantly by linear regression analysis with the total time to wean in days (-11.6 + 0.93 for OCB, r = .79; and −12.6 + 293.1 for OCB/Vo2 SV, r = .84, p < .001 for both). As the OCB was correlated with the total wean time, this variable may be a useful index of the effect of many influences on the weaning process.

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