Hemodynamic response to discontinuance of mechanical ventilation

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Abstract
Homodynamic monitoring during discontinuance of mechanical ventilation revealed that some post-cardiomy patients who were ready for weaning, by the usual criteria, responded with a sudden unexpected reduction in cardiac output. This paradoxical decrease in cardiac output was not correlated with a decreased arterial oxygen tension or other blood gas changes, but was associated with reduced oxygen availability and consumption as well as increased pulmonary vascular resistance. Subsequent weaning attempts were successful in 16 of these 18 patients and repeated cardiac output determinations in a few showed “recovery” of the heart with in-creased cardiac output upon discontinuance of the ventilator.

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