Pulmonary mechanics in patients with prolonged mechanical ventilation requiring tracheostomy

Meng-Chih Lin*, C. C. Huang, Cheng-Ta Yang, Y. H. Tsai, Chang-Yao Thomas Tsao

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

39 Scopus citations

Abstract

This study was performed to assess the changes in pulmonary mechanics before and after tracheostomy in patients with prolonged mechanical ventilation and to detect pre-tracheostomy physiologic factors that predict the outcome of weaning from mechanical ventilation. Pulmonary mechanics were recorded before and after tracheostomy in 20 patients. Work of breathing, mean airway resistance and pressure/time product showed no significant differences after tracheostomy. Peak inspiratory pressure was significantly reduced (pre 33.4 ± 11.8 vs post 28.6 ± 9.2 mmHg). There was no difference in age or duration of mechanical ventilation between two different groups according to the outcome (weaned and not-weaned). Pre-tracheostomy intrinsic positive and expiratory pressure (PEEP(i)) was significantly lower in the weaned group (1.1 ± 1.6 vs 2.7 ± 1.4 mmHg). A significant difference was also found in pre-tracheostomy compliance (C(static)) (47.3 ± 36.9 vs 28.8 ± 16.5 ml/cmH2O). We concluded that tracheostomy changed pulmonary mechanics very little except for a fall in peak inspiratory pressure. Patients who had better underlying lung mechanics (higher C(static) and lower PEEP(i)) had better chances of weaning from mechanical ventilation after tracheostomy.

Original languageEnglish
Pages (from-to)581-585
Number of pages5
JournalAnaesthesia and Intensive Care
Volume27
Issue number6
DOIs
StatePublished - 12 1999

Keywords

  • Lung: pulmonary mechanics, tracheostomy, mechanical ventilation, weaning, work of breathing, lung compliance

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