The reduction of weaning time from mechanical ventilation using tidal volume and relaxation biofeedback.
We sought to determine if biofeedback could reduce weaning time for the hard-to-wean patient by improving important weaning factors that are not effectively dealt with by present weaning methods. These include respiratory muscle electromyograph (EMG) efficiency, respiratory drive, and the anxiety of the ventilator-dependent patient. After the patient had received mechanical ventilation for 7 days and the day weaning began (start), the patient was randomly assigned to biofeedback or to the control group. There were 20 patients assigned to each group, with mean ages of 60.2 (biofeedback) and 59.3 (control) yr. The patients assigned to the biofeedback group received daily, until extubation or being placed on no resuscitation status (termination), frontalis electromyographic (EMG) relaxation feedback for anxiety reduction and improved respiratory muscle EMG efficiency, tidal volume/diaphragm EMG (VT/DAP), and VT feedback for increasing VT and respiratory drive defined as tidal volume/inspiratory time (VT/TI). The control group was visited daily to control for attention and reassurance. The results showed a significant (p less than 0.01) reduction in mean ventilator days for the biofeedback group of 20.6 +/- 8.9 SD compared with 32.6 +/- 17.6 SD mean days for the control group. From start to termination, there was a significant (p less than 0.01) increase in baseline VT, from 295 +/- 41 to 415 +/- 45 ml, and a significant (p less than 0.02) increase in VT/DAP, from 0.33 +/- 0.09 to 0.94 +/- 0.22 L/mV for the biofeedback group but no significant change in these parameters for the control group.(ABSTRACT TRUNCATED AT 250 WORDS)
Holliday
J E
JE
Division of Pulmonology, St. Louis University Medical School, Missouri.
Hyers
T M
TM
D000328:Adult; D000368:Aged; D001676:Biofeedback, Psychology; D004576:Electromyography; D005260:Female; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D012064:Relaxation Therapy; D012132:Respiratory Muscles / Q000502:physiology; D013990:Tidal Volume; D013997:Time Factors; D015300:Ventilator Weaning / Q000379:methods*