Abstract
Previous studies on oxygen consumption (\(\dot V_{O_2 } \)) during weaning from mechanical ventilation assumed that an increase in\(\dot V_{O_2 } \) (Δ\(\dot V_{O_2 } \)) reflected oxygen consumption by respiratory muscles (\(\dot V_{O_2 RESP} \)), and proposed Δ\(\dot V_{O_2 } \) as a weaning predictor. We measured\(\dot V_{O_2 } \) CO2 production (\(\dot V_{CO_2 } \)) and plasma catecholamines in 20 short-term ventilated patients during weaning by SIMV and CPAP. Δ\(\dot V_{O_2 } \) as a percentage of\(\dot V_{O_2 } \) during spontaneous ventilation (Δ\(\dot V_{O_2 } \) %) ranged from 4.8% to 41.5%.\(\dot V_{CO_2 } \) also increased and correlated with\(\dot V_{O_2 } \). Plasma adrenaline and noradrenaline increased significantly to levels known to produce considerable increases in metabolic rate. Mean arterial pressure and heart rate concomitantly increased, but spontaneous minute ventilation decreased. Thus, since the increased plasma catecholamines are calorigenic, the assumption that Δ\(\dot V_{O_2 } \) represents\(\dot V_{O_2 RESP} \) is incorrect. Although mean Δ\(\dot V_{O_2 } \) % of successfully weaned patients was significantly less than that of failure-to-wean patients, the wide scatter of individual values in the latter group excludes Δ\(\dot V_{O_2 } \) % as an accurate weaning predictor.
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Oh, T.E., Bhatt, S., Lin, E.S. et al. Plasma catecholamines and oxygen consumption during weaning from mechanical ventilation. Intensive Care Med 17, 199–203 (1991). https://doi.org/10.1007/BF01709877
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DOI: https://doi.org/10.1007/BF01709877