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Effect of flumazenil on diaphragm electrical activation during weaning from mechanical ventilation after acute respiratory distress syndrome

dc.rights.licenseopenen_US
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorROZÉ, H.
dc.contributor.authorGERMAIN, A.
dc.contributor.authorPERRIER, V.
dc.contributor.authorDEWITTE, A.
dc.contributor.authorJOANNES-BOYAU, O.
dc.contributor.authorFLEUREAU, C.
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorOUATTARA, A.
dc.date.accessioned2020-10-27T12:29:51Z
dc.date.available2020-10-27T12:29:51Z
dc.date.issued2015-02
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/11494
dc.description.abstractEnBACKGROUND: Diaphragm electrical activation (EAdi) and the ratio of tidal volume to EAdi (VT/EAdi) may provide clinical information on neuroventilatory efficiency (NVE) in patients being weaned from mechanical ventilation. We tested the hypothesis that residual sedation could interfere with respiratory recovery, by assessing the effects of flumazenil on EAdi and VT/EAdi ratio. METHODS: This observational study included 13 patients breathing with pressure-support ventilation (PSV) after a long period of controlled mechanical ventilation (i.e. \textgreater4 days) plus midazolam-based sedation for acute respiratory distress syndrome. EAdi and respiratory patterns were compared before and after a bolus of flumazenil, which was given because neurological status needed to be evaluated. RESULTS: Flumazenil induced a significant increase in EAdi [+71 (41-123)%, P=0.0002] and VT [+17 (8-32)%, P=0.0005], resulting in significantly decreased NVE [-34 (15-43)%]. The increased VT was significantly correlated with the increased EAdi (ρ=0.70, P=0.009). CONCLUSIONS: During weaning from mechanical ventilation, the diaphragmatic contribution to the breathing process may be reduced by residual midazolam-induced ventilatory depression. The increased EAdi with reversal of residual sedation was associated with a proportional increase in VT. These findings should be considered by the attending physician when interpreting daily EAdi and VT changes during weaning from mechanical ventilation.
dc.language.isoENen_US
dc.subjectArticle CLINIQUE
dc.subject.enElectrical Diaphragm Activation
dc.subject.enMechanical Ventilation
dc.subject.enSedation
dc.subject.enTidal Volume/Physiology
dc.title.enEffect of flumazenil on diaphragm electrical activation during weaning from mechanical ventilation after acute respiratory distress syndrome
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/bja/aeu374en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
dc.identifier.pubmed25416275en_US
bordeaux.journalBritish Journal of Anaesthesiaen_US
bordeaux.page269–275en_US
bordeaux.volume114en_US
bordeaux.hal.laboratoriesBiologie des maladies cardiovasculaires - U1034en_US
bordeaux.issue2en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
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