Articles: mechanical-ventilation.
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Journal of anesthesia · Dec 1997
Effect of fentanyl on heart rate variability during mechanical ventilation.
This study was performed to investigate the effect of fentanyl alone on heart rate variability (HRV) during mechanical ventilation using power spectral analysis. Arterial baroreceptor reflex was also tested with pharmacological manipulation to assess the contribution of vagal baroreceptor reflex modulation of HRV during fentanyl anesthesia. ⋯ Our data indicate that fentanyl modulates the respiratory frequency fluctuation of HRV. This is partly caused by the effects of fentanyl on arterial baroreflex sensitivity.
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In the intensive care unit (ICU) setting, the combination of mechanical ventilation and renal replacement therapy (RRT) has been associated with prolonged length of hospital stay, high cost of care and poor outcome. We gathered outcome data on patients who had severe renal dysfunction on transfer to our regional weaning center (RWC) for attempted weaning from prolonged mechanical ventilation (PMV). We screened the admission laboratory values of 1077 patients transferred to our RWC over an 8-year period. We reviewed the medical records of patients with serum creatinine > 2.5 mg/dl. ⋯ Patients who require PMV and RRT have a very poor prognosis. The small number of patients with renal insufficiency not requiring RRT had a more favorable hospital outcome and mortality, but long-term survival remained poor.