Biomedical subjects

H B Gazeroglu

Publications and source records attributed to H B Gazeroglu.

4 recordsLinked to original sources

PubMed1989

Evaluation of conventional criteria for predicting successful weaning from mechanical ventilatory support in elderly patients.

To assess whether the accepted weaning parameters (derived from middle-aged patients) are helpful in determining discontinuation of mechanical ventilatory support (MVS) in elderly patients, we retrospectively reviewed records of 269 patients greater than or equal to 70 yr who were weaned from MVS from January, 1984 through June, 1985 at one institution. Parameters studied included spontaneous respiratory rate, tidal volume, minute ventilation, maximal inspiratory pressure (MIP), pH, PaCO2, PaO2, and PaO2/FiO2. Two hundred forty-one patients (mean age 80 yr) were successfully weaned while 28 patients (mean age 80 yr) required reinstitution of MVS within 48 h. MIP and pH were statistically lower in the unsuccessfully weaned group, although the mean absolute differences were small (-32 vs. -38 cm H2O and 7.42 vs. 7.44 cm H2O, respectively). All parameters had good positive predictive values but poor negative predictive values (less than or equal to 22%) and only marginal diagnostic accuracy (58% to 86%). We conclude that strict adherence to previously published weaning parameters may not be applicable in deciding when to discontinue MVS in elderly patients.

Aged↗

PubMed1988

Variability of the breathing pattern before and after extubation.

A stable breathing pattern during unassisted ventilation through an endotracheal tube (ETT) prior to extubation is an important factor in determining whether a patient can be successfully extubated. Proper interpretation of changes in the breathing pattern requires knowledge of the normal variability of the breathing pattern in critically ill, intubated patients. To establish these guidelines, 50 spontaneously breathing patients who were being weaned from mechanical ventilation were monitored with respiratory inductive plethysmography for one hour immediately prior to and following successful extubation. Immediately after extubation, respiratory rate (f), tidal volume (VT), minute ventilation, and mean inspiratory flow increased slightly. By 30 minutes postextubation, these parameters were similar to preextubation values. There was no significant change in variability of f or VT. Although the breathing pattern of these relatively stable, intensive care patients differed from values of normal ambulatory subjects, values were similar in the preextubation and postextubation periods.

Adult↗

PubMed1983

Breathing patterns. 1. Normal subjects.

Ventilatory monitoring devices that require mouthpiece breathing produce a rise in tidal volume (VT), a fall in frequency (f) and alterations in periodicity and variability of breathing components. Together with the introduction of the respiratory inductive plethysmograph, a reliable noninvasive monitoring device of ventilation, major advances have taken place in understanding the significance of the components of the breathing pattern. We measured the breathing pattern of normal subjects utilizing respiratory inductive plethysmography and continuously processed these data with a microprocessor system. The mean values of the breathing pattern components in normal subjects were not affected by age, but the rhythmicity was more irregular in the elderly. The values of breathing pattern components obtained noninvasively by respiratory inductive plethysmography in normal subjects are fairly predictable in limits similar to other tests of pulmonary function.

Adult↗

PubMed1983

Breathing patterns. 2. Diseased subjects.

We measured the breathing pattern of normal subjects, asymptomatic smokers, asymptomatic and symptomatic asthmatic patients, and patients with chronic obstructive pulmonary disease, restrictive lung disease, primary pulmonary hypertension and anxiety state utilizing respiratory inductive plethysmography. Respiratory rate was increased above the normal in smokers and in patients with COPD, restrictive lung disease and pulmonary hypertension, but remained normal in asthmatic patients. Inspiratory times (T1) of one second or less often occurred in patients with COPD, restrictive lung disease, and pulmonary hypertension. Smokers and patients with symptomatic asthma, COPD, restrictive lung disease and pulmonary hypertension showed heightened respiratory center drive as reflected by elevated mean inspiratory flow (VT/TI). Fractional inspiratory time was reduced to a variable extent in smokers, symptomatic asthmatic patients and patients with COPD, and was a weak indicator of airways obstruction. Patients with COPD often had major fluctuations of expiratory timing, periodic fluctuations of end-expiratory level, and asynchrony between rib cage and abdominal movements. Chronic anxiety was characterized by frequent sighs; episodic rapid rates alternating with apneas were less common. We conclude that analysis of breathing patterns provides diagnostic discrimination among normal subjects and disease states.

Adult↗