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Neuroventilatory efficiency and extubation readiness in critically ill patients

Overview of attention for article published in Critical Care, July 2012
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94 Mendeley
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Title
Neuroventilatory efficiency and extubation readiness in critically ill patients
Published in
Critical Care, July 2012
DOI 10.1186/cc11451
Pubmed ID
Abstract

ABSTRACT: INTRODUCTION: Based on the hypothesis that failure of weaning from mechanical ventilation is caused by respiratory demand exceeding the capacity of the respiratory muscles, we evaluated whether extubation failure could be characterized by increased respiratory drive and impaired efficiency to generate inspiratory pressure and ventilation. METHODS: Airway pressure, flow, volume, breathing frequency, and diaphragm electrical activity were measured in a heterogeneous group of patients deemed ready for a spontaneous breathing trial. Efficiency to convert neuromuscular activity into inspiratory pressure was calculated as the ratio of negative airway pressure and diaphragm electrical activity during an inspiratory occlusion. Efficiency to convert neuromuscular activity into volume was calculated as the ratio of the tidal volume to diaphragm electrical activity. All variables were obtained during a 30-minute spontaneous breathing trial on continuous positive airway pressure (CPAP) of 5 cm H2O and compared between patients for whom extubation succeeded with those for whom either the spontaneous breathing trial failed or for those who passed, but then the extubation failed. RESULTS: Of 52 patients enrolled in the study, 35 (67.3%) were successfully extubated, and 17 (32.7%) were not. Patients for whom it failed had higher diaphragm electrical activity (48%; P < 0.001) and a lower efficiency to convert neuromuscular activity into inspiratory pressure and tidal volume (40% (P < 0.001) and 53% (P < 0.001)), respectively. Neuroventilatory efficiency demonstrated the greatest predictability for weaning success. CONCLUSIONS: This study shows that a mixed group of critically ill patients for whom weaning fails have increased neural respiratory drive and impaired ability to convert neuromuscular activity into tidal ventilation, in part because of diaphragm weakness. TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT01065428. ©2012 Liu et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Mendeley readers

The data shown below were compiled from readership statistics for 94 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 3 3%
Italy 1 1%
Chile 1 1%
Germany 1 1%
Czechia 1 1%
United States 1 1%
Unknown 86 91%

Demographic breakdown

Readers by professional status Count As %
Researcher 20 21%
Other 15 16%
Student > Postgraduate 11 12%
Student > Bachelor 8 9%
Student > Master 7 7%
Other 23 24%
Unknown 10 11%
Readers by discipline Count As %
Medicine and Dentistry 56 60%
Nursing and Health Professions 10 11%
Computer Science 4 4%
Immunology and Microbiology 2 2%
Psychology 1 1%
Other 3 3%
Unknown 18 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 August 2012.
All research outputs
#2,016,407
of 3,629,051 outputs
Outputs from Critical Care
#1,396
of 2,157 outputs
Outputs of similar age
#35,554
of 74,845 outputs
Outputs of similar age from Critical Care
#79
of 117 outputs
Altmetric has tracked 3,629,051 research outputs across all sources so far. This one is in the 25th percentile – i.e., 25% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,157 research outputs from this source. They receive a mean Attention Score of 4.1. This one is in the 20th percentile – i.e., 20% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 74,845 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 35th percentile – i.e., 35% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 117 others from the same source and published within six weeks on either side of this one. This one is in the 20th percentile – i.e., 20% of its contemporaries scored the same or lower than it.