scholarly journals Weaning in der neurologischen Frührehabilitation (NFR)

2021 ◽  
Vol 27 (4) ◽  
pp. 233-238
Author(s):  
J. D. Rollnik
Keyword(s):  
Intensive Care ◽  
Spontaneous Breathing ◽  
German Society ◽  
Early Rehabilitation ◽  
Prolonged Weaning ◽  
Gradual Expansion

Weaning in neurological early rehabilitation represents an important participation goal that can be achieved in up to 90% of cases after an average of two to three weeks of weaning through a combination of intensive care and rehabilitative interventions. The weaning process should be based on a standardized weaning protocol, with which a gradual expansion of spontaneous breathing phases can be achieved. The German Society for Neurorehabilitation (DGNR) has taken the special features of prolonged weaning in NFR into account in a separate guideline.

Patients on Weaning Trials Classified with Neural Networks and Features Selection

2008 ◽  
pp. 1061-1067
Author(s):  
B. Giraldo ◽  
A. Garde ◽  
C. Arizmendi ◽  
R. Jane ◽  
I. Diaz ◽  
...  
Keyword(s):  
Neural Network ◽  
Neural Networks ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Spontaneous Breathing ◽  
Selection Procedure ◽  
Respiratory Pattern ◽  
Features Selection ◽  
Weaning From Mechanical Ventilation ◽  
Pattern Variability

One of the challenges in intensive care is the process of weaning from mechanical ventilation. We studied the differences in respiratory pattern variability between patients capable of maintaining spontaneous breathing during weaning trials, and patients that fail to maintain spontaneous breathing. In this work, neural networks were applied to study these differences. 64 patients from mechanical ventilation are studied: Group S with 32 patients with Successful trials, and Group F with 32 patients that Failed to maintain spontaneous breathing and were reconnected. A performance of 64.56% of well classified patients was obtained using a neural network trained with the whole set of 35 features. After the application of a feature selection procedure (backward selection) 84.25% was obtained using only eight of the 35 features.

scholarly journals Effectiveness of early rehabilitation on patients with chronic obstructive lung disease and acute respiratory failure in intensive care units: A case–control study

2019 ◽  
Vol 16 ◽  
pp. 147997311882031
Author(s):  
Willy Chou ◽  
Chih-Cheng Lai ◽  
Kuo-Chen Cheng ◽  
Kuo-Shu Yuan ◽  
Chin-Ming Chen ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Intensive Care Units ◽  
Case Control Study ◽  
Case Control ◽  
Early Rehabilitation ◽  
Chronic Obstructive ◽  
Copd Patients ◽  
Control Study

The effect of early rehabilitation on the outcome of patients with chronic obstructive pulmonary disease (COPD) and acute respiratory failure (ARF) in intensive care units (ICUs) remains unclear. We examined the effect of early rehabilitation on the outcomes of COPD patients requiring mechanical ventilation (MV) in the ICU. This retrospective, observational, case–control study was conducted in a medical center with a 19-bed ICU. The records of all 105 ICU patients with COPD and ARF who required MV from January to December 2011 were examined. The outcomes (MV duration, rates of successful weaning and survival, lengths of ICU and hospital stays, and medical costs) were recorded and analyzed. During the study period, 35 patients with COPD underwent early rehabilitation in the ICU and 70 demographically and clinically matched patients with similar COPD stage, cause of intubation, type of respiratory failure, and levels of disease severity who had not undergone early rehabilitation in the ICU were selected as comparative controls. Multiple regression analysis showed that early rehabilitation was significantly negatively associated with MV duration. Early rehabilitation for COPD patients in the ICU with ARF shortened the duration of their MV.

scholarly journals Semiquantitative Cough Strength Score for Predicting Reintubation After Planned Extubation

2015 ◽  
Vol 24 (6) ◽  
pp. e86-e90 ◽  
Author(s):  
Jun Duan ◽  
Lintong Zhou ◽  
Meiling Xiao ◽  
Jinhua Liu ◽  
Xiangmei Yang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Spontaneous Breathing ◽  
Operating Characteristic ◽  
Peak Flow ◽  
Characteristic Curve ◽  
Spontaneous Breathing Trial ◽  
Extubation Outcome ◽  
Cough Strength ◽  
Operating Characteristic Curve

Background Semiquantitative cough strength score (SCSS, graded 0–5) and cough peak flow (CPF) have been used to predict extubation outcome in patients in whom extubation is planned; however, the correlation of the 2 assessments is unclear. Methods In the intensive care unit of a university-affiliated hospital, 186 patients who were ready for extubation after a successful spontaneous breathing trial were enrolled in the study. Both SCSS and CPF were assessed before extubation. Reintubation was recorded 72 hours after extubation. Results Reintubation rate was 15.1% within 72 hours after planned extubation. Patients in whom extubation was successful had higher SCSSs than did reintubated patients (mean [SD], 3.2 [1.6] vs 2.2 [1.6], P = .002) and CPF (74.3 [40.0] vs 51.7 [29.4] L/min, P = .005). The SCSS showed a positive correlation with CPF (r = 0.69, P < .001). Mean CPFs were 38.36 L/min, 39.51 L/min, 44.67 L/min, 57.54 L/min, 78.96 L/min, and 113.69 L/min in patients with SCSSs of 0, 1, 2, 3, 4, and 5, respectively. The discriminatory power for reintubation, evidenced by area under the receiver operating characteristic curve, was similar: 0.677 for SCSS and 0.678 for CPF (P = .97). As SCSS increased (from 0 to 1 to 2 to 3 to 4 to 5), the reintubation rate decreased (from 29.4% to 25.0% to 19.4% to 16.1% to 13.2% to 4.1%). Conclusions SCSS was convenient to measure at the bedside. It was positively correlated with CPF and had the same accuracy for predicting reintubation after planned extubation.

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