Comparison of CPAP with Humidifie, Blender, and T-piece on the Outcome of Weaning in Patients with Neurological Disorders
Iranian Journal of Child Neurology,
Vol. 9 No. 2 (2015),
1 April 2015
,
Page 42-45
https://doi.org/10.22037/ijcn.v9i2.6615
Abstract
How to Cite This Article: Bilan N, Ganji Sh. Comparison of CPAP with Humidifie, Blender, and T-piece on the Outcome of Weaning in Patients with Neurological Disorders. Iran J Child Neurol. Spring 2015;9(2):42-45.
Abstract
Objective
The procedure for weaning from mechanical ventilation in many patients is a difficult and long process and increases the time of mechanical ventilation. There are numerous ways to achieve weaning. One common method is the use of CPAP. Considering the lower price of a humidifier, blender, and T-piece compared with CPAP and in light of the limited number of studies in this field the current study purposed to compare these two procedures.
Materials & Methods
Fifty-one patients with neurological disorders who were under mechanical ventilation and ready to wean were allocated randomly into two groups: the CPAP group and the humidifier, blender, and T-piece group. Duration of hospital and PICU stay, number of days under mechanical ventilation, frequency of re-intubation, and mortality rate among patients were documented.
Results
The patients were 33 males and 18 females (64.7% and 35.3%, respectively) with an average age of 22.5 ± 4.5 months.
The main indication for intubation was impending respiratory failure.
Hospital stay was 22±15 and 21±13 days for the humidifier and CPAP groups, respectively.
PICU stay was 13±11 and 21±13 days for the humidifier and CPAP groups, respectively. Re-intubation rates were 17.2% and 45.5% for the humidifier and CPAP groups, respectively.
Mortality rates were 3.4% and 22.5% for the humidifier and CPAP groups, respectively.
Conclusion
Considering no statistically significant difference between the two groups, using the humidifier, blender, and T-piece is recommended.
- CPAP
- T-piece
- Blender
- Humidifier
- Neurological disorder
How to Cite
References
Esteban A, Alia I, Ibanez J, Benito S, Tobin MJ. Models of mechanical ventilation and weaning. A national
survey of Spanish hospitals. The Spanish Lung Failure Collaborative Group. Chest, 1994; 106(4):1188-93.
Esteban A, Anzueto A, Frutos F, et al. Characteristics and outcomes in adult patients receiving mechanical
ventilation: a 28-day international study. JAMA, 2002; 287(3):345-55.
Esteban A, Anzueto A, Alı´a I, et al. How is mechanical ventilation employed in the Intensive Care Unit? An international utilization review. Am J Respir Crit Care Med; 2000; 161: 1450–8.
Newton NI.(1991) Supplementary oxygen – potential for disaster. Anaesthesia; 46: 905–6.
Cook DJ, Dejonghe B, Brochard L, et al. Influence of airway management on ventilator- associated pneumonia. JAMA; 1998; 279: 781–787.
Kollef MH, Shapiro SD, Silver P, et al.A randomized, controlled trial of protocol-directed versus hysician directed weaning from mechanical ventilation. Crit Care Med, 1997; 25:567-74.
Marelich GP, Murin S, Battistella F, et al. Protocol weaning of mechanical ventilation in medical and surgical patients by respiratory care practitioners and nurses. Effect on weaning time and incidence of ventilator associated pneumonia. Chest, 2000; 118:459-67.
Esteban A, Alia I, Gordo F, et al. Extubation outcome after spontaneous breathing trials with t-tube or pressure support ventilation. Am J Respir Crit Care Med, 1997;156:459-65.
Esteban A, Alia I, Tobin MJ. Effect of spontaneous breathing trial duration on outcome of attempts to discontinue mechanical ventilation. Am J Respir Crit Care Med, 1999; 159:512-8.
Luhr OR, Antonsen K, Karlsson M, et al. Incidence and mortality after acute respiratory failure and acute
respiratory distress syndrome in Sweden, Denmark, and Iceland. The ARF Study Group. Am J Respir Crit Care Med, 159, 1999; 1849–1861.
Pingleton S. Complications of acute respiratory failure. Am J Respir Crit Care Med, 1988; 137, 1463–1493.
Forbes AR. Temperature, humidity and mucus flow in the intubated trachea. Br J Anaesth, 1974; 46, 29–34.
Chalon J, Patel C, Ali M, et al. Humidity and the anaesthetized patient.Anesthesiol, 1979; 50, 195–198.
Noguchi H, Takumi Y, Rochi O.A study of the humidification in tracheostomized dogs. Br J Anaesth,
; 45, 844–847.
Esteban A, Anzueto A, Alı´a I, et al. How is mechanical ventilation employed in the Intensive Care Unit? An international utilization review.Am J RespirCrit Care Med, 2000; 161, 1450–8.
Jones DP, Byrne P, Morgan C, et al. Positive End- Expiratory Pressure vs. T-Piece. Chest, 100(6), 1991;
-59.
Molina-Saldarriaga FJ, Fonseca-Ruiz NJ, Cuesta-Castro DP, Esteban A, Frutos-Vivar F. Spontaneous breathing trial in chronic obstructive pulmonary disease: continuous positive airway pressure (CPAP) versus T-piece. Med Intensiva, 2010; 34(7), 453-8.
Vats N, Singh J, Kalra S. Extubation outcome after spontaneous breathing trials with T-tube or pressure
support ventilation. Indian Journal of Physiotherapy & Occupational Therapy, 2012; 6(2), 86-89.
Lellouche F, Maggiore SM, Deye N, et al. Effect of the humidification device on the work of breathing during noninvasive ventilation. Intensive Care Med 2002; 28:1582–1589.
Jaber S, Chanques G, Matecki S, et al. Comparison of the effects of heat and moisture exchangers and heated humidifiers on ventilation and gas exchange during noninvasive ventilation. Intensive Care Med, 2002; 28, 1590–1594.
- Abstract Viewed: 328 times