An Observational Study to Assess the Correlation between Rapid Shallow Breathing Index and Handgrip Strength in Weaning Patients from Mechanical Ventilation | Chapter 8 | Medical Science: Trends and Innovations Vol. 6

Background: Weaning patients from mechanical ventilation is a crucial part of ICU care. There are various indices and criteria to help with the same. We chose to explore the significance of HGS – Hand grip strength and RSBI – Rapid shallow breathing index. RSBI is a well-established tool to assess the patient’s progress before going in for the Spontaneous Breathing Trial - SBT. HGS on the other hand is another tool to check and ascertain the strength of the respiratory muscles.

Aim: The aim of the study was to evaluate the correlation that could exist between HGS and RSBI in order to go ahead with weaning from mechanical ventilation. This was our primary objective. The secondary objective was to recognize the difference in HGS between the groups of successful weaning and failed weaning and also to find the differences in HGS between the groups of simple weaning, difficult weaning and prolonged weaning.

Methods: In this prospective study, patients who fulfilled the criteria of being ready to be weaned off mechanical ventilation, underwent a Spontaneous Breathing Trail - SBT. During the preliminary SBT, data such as vital signs, RSBI, type of SBT, time of SBT success, and time of extubation were also collected. HGS was assessed using a Jamar dynamometer in kilograms. HGS was tested at 48 hours post intubation 10 minutes prior to SBT and 30 minutes post SBT. In addition, this measurement was also further tested 1 hour after extubation. RSBI and HGS tests were both tested 10 minutes before the SBT.

Results: Thirty-seven mechanically ventilated patients were included in this study and all these patients were also included in the final analysis. There were 24(64.86%) males. The mean age was found to be 55.32±15.58 years. APACHE II score was found to be 14.108± 5.26. Majority of the patients were intubated due to pneumonia (5%, 2 of 37 patients). The most widely used SBT in our study was pressure support ventilation (95%, 35 of 37 patients). The highest HGS was demonstrated at 1 hour post-extubation (14.14± 0.65Kg). RSBI tested 10 minutes before SBT was found to be 54.89± 9.85 breaths/min/L.

Conclusion:

Ø  This study has helped us arrive at the conclusion that HGS and RSBI seem to have a positive correlation in ICU patients who were weaned from mechanical ventilation.

Ø  RSBI is a main indicator for successful weaning.

 

Author (s) Details

Swetha Ramani Chinnappan Kuppusamy
Department of Anaesthesiology, SRM Medical College and hospital, Kattankulathur-603203, India.

 

Saranya Babu
Department of Anaesthesiology, SRM Medical College and hospital, Kattankulathur-603203, India.

 

Chandhinie Ramesh
Department of Anaesthesiology, SRM Medical College and hospital, Kattankulathur-603203, India.

 

Pushparani Anand
Department of Anaesthesiology, SRM Medical College and hospital, Kattankulathur-603203, India.

 

Mirunalini Gunaseelan
Department of Anaesthesiology, SRM Medical College and hospital, Kattankulathur-603203, India.

 

Karthik Kandan
Department of Anaesthesiology, SRM Medical College and hospital, Kattankulathur-603203, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v6/4216

Cardiorespiratory Interactions: Exploring the Impact of Spontaneous and Mechanical Ventilation on Heart Rate Variability | Chapter 3 | Medical Research and Its Applications Vol. 6

The purpose of this research method paper is to describe the physiological influence of spontaneous and MV on frequency-based measures of HRV. It has been demonstrated that frequency-based measurements of heart rate variability are a valuable physiological marker that sheds light on how the autonomic nervous system functions in both clinical and research contexts. Because of their physical location within the confined thoracic chamber, the heart and lungs are continuously controlled by the autonomic nervous system during each ventilation cycle. The typical mechanics of the ventilator are altered by mechanical ventilation and its subsequent removal, which results in changes to the intrathoracic pressure, tidal volume, and oxygen supply.  A non-invasive method called Heart rate variability (HRV) can be used to evaluate this interaction during ventilation and can be quantified by applying frequency-based measures of the variability between heartbeats. Although HRV is a reliable method to measure the alteration of Autonomic Nervous System (ANS) function and cardiopulmonary interaction, there have been limited reports concerning the changes in the frequency-based measure of HRV during both spontaneous and mechanical ventilation. By understanding the effect of different types of ventilation (spontaneous, MV, weaning process) on the cardiovascular system, the simple determinants of lung-heart interactions will be accurate, provide the most efficient treatment to patients in a critical setting, and consider respiratory support as a confounding variable that might affect the high-frequency measure of HRV in respiratory distress patients with MV, and during the weaning process.

 

Author(s)details:-

 

Khlood Bubshait
Fundamental of Nursing Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

 

Please See the book here :-  https://doi.org/10.9734/bpi/mria/v6/473

Evaluation of Hearing in High-risk Neonates and Children at a Tertiary Care Hospital through Otoacoustic Emissions and Auditory Brainstem Responses: A Prospective Study and Literature Review | Chapter 1 | Novel Research Aspects in Medicine and Medical Science Vol. 6

 Objective: To judge otoacoustic emissions (OAE) and auditory brainstem answers (ABR) for screening physical incapacity among high-risk neonates and babies and to assess awareness, and positive and negative predictive principles of OAE in comparison accompanying ABR.Methods: A total of 76 children were screened containing high-risk neonates and juveniles. OAE and ABR were done simultaneously on all the study shareholders.Results:  The prevalence of hearing misfortune among the study state was 21.05% (high-risk NICU graduates 13.6 %; high-risk offsprings 31.25%). Among the high-risk NICU graduates, risk determinants that were significantly associated with trial loss were beginning weight less than 1500g, meningitis, machinelike ventilation for in addition to 3 days, and TORCH infections. Among high-risk adolescents, factors significantly guide hearing deficit were ototoxic drugs, meningoencephalitis and cerebral palsy with all-encompassing developmental delay. OAE and ABR tests secondhand simultaneously to screen high-risk study communities showed that OAE has good precision and is thereby comparable to ABR. The overall awareness and specificity of OAE in comparison to ABR were 62.50% and 93.33% individually.Conclusion: TEOAE was found expected a simple, non-invasive, short-event, cost-effective means and suitable for hearing hide in high risk toddlers. However, all high-risk newborns should be secluded with ABR to discover hearing loss as OAE has less feeling.

Author(s) Details:

Shalini G. N.,
Arogya Adhar Hospital, Belagavi, Karnataka, India.

Rajesh K. Kulkarni,
Post Graduate Institute-YCM Hospital, Pune, India.

Rupali R. Bavikar,
Department of Pathology, D. Y. Patil Medical College, Pune, India.

Aarti Kinikar,
Department of Pediatrics, Vice Dean, B. J. Government Medical College, Pune, India.

Please see the link here: https://stm.bookpi.org/NRAMMS-V6/article/view/12138