Authors: M ESCOBAR; GE GIULIANO; ME URDAPILLETA; J LEBUS; G GADEA; GG MOREL VULLIEZ; EL DE VITO
Location: Córdoba, Argentine
Meeting: 19th Argentine Congress of Intensive Care; 2009. Organizing Institution: Argentina Society of Critical Care Medicine. INTRODUCTION: The Marini´s maneuver (Chest 1992) has standardized the quantification of Pimax´s non collaborators patients by occluding airway for 20 seconds. To our knowledge there is no information regarding Pimax´s values during occlusions over 20 seconds. The objective was to quantify the Pimax´s occlusion during airway extended to 40 seconds. Material and Methods: 12 patients with tracheostomy, 5 patients were long term mechanical ventilation (9/12 no collaborators). Age 57 (22-85), 7 males. Flow and pressure were determined in the trachea breath by breath (FluxMed GR, MBMed SA), Fr, SatO2, Fc, TA. The pressure and flow signals were recorded and subsequently analyzed (AcqKnowledge, Biopac). Results: Pimax 20 sec: 31.75 ± 14.84, Pimax 40 sec: 51.17 ± 20.91 (p <0.0001). Pimax 20 seconds in they had <25 cmH2O (n 3): 11.7 ± 1.5, 40 sec Pimax: 24.0 ± 8.5 (p <0.124, 2/3 patients achieved Pimax 40> 25 cmH2O). Discussion: 1) The extent of occlusion to 40 seconds significantly increased values Pimax, 2) There were no undesirable side effects, 3) This extension should be considered in patients with Pimax-20 sec <25 cmH2O that could be identified as candidates try maneuvers to weaning to mechanical ventilation, 4) in patients with Pimax-20 seg > 25 cmH2O could get more actual values of Pimax.