P0.1は急性呼吸不全患者のweaningの指標として有用か

Is Airway Occlusion Pressure Useful to Predict Successful Weaning from Mechanical Ventilation in Patients with Acute Respiratory Failure?

　急性呼吸不全患者でP_0.1がweaningの指標となり得るか否かを検討した．weaning成功群と失敗群でP_0.1を測定し他の換気パラメータと比較した．P_0.1が増加していればweaningできない可能性が高いが，P_0.1は症例によるバラツキが大きくweaning成功群と失敗群で重複も認められるため100％信頼できる指標とは言えない．また呼吸数，分時換気量，PaO₂，酸素等量など従来からのweaningの指標に比してより優れているとは言えない．したがって，P_0.1は急性呼吸不全患者のweaningの指標となり得るが，従来の指標との組み合わせで総合的にweaningの可否を判断するべきであり，いくつかの指標の一つと考えた方がよい．

The purpose of this study was to evaluate whether airway occlusion pressure (P_0.1) would be a useful predictor for successful weaning in mechanically ventilated patients with acute respiratory failure. We studied 23 merginal weaning candidates. Fourteen patients were able to be weaned from the ventilator, and 9 patients were not able to be weaned. P_0.1 and other respiratory parameters were measured just prior to weaning and at the end of weaning or at the time of discontinuation of weaning. The mean value of P_0.1 in the failed group was higher than that in the successful group both before and after weaning periods.