Assessing agreement among non-invasive indicators for inspiratory effort during pressure support ventilation.

IF 3.1 3区医学 Q1 MEDICINE, GENERAL & INTERNAL Frontiers in Medicine Pub Date : 2025-03-05 eCollection Date: 2025-01-01 DOI:10.3389/fmed.2025.1561017

Wen-Yi Lv, Shuai Liu, Linlin Zhang, Jian-Xin Zhou

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Abstract

Background: During pressure support ventilation (PSV), the accuracy of non-invasive indicators in diagnosing high or low inspiratory effort has been validated. However, the correlation and agreement of these indicators remain unclear. This study aims to investigate the correlation and agreement among non-invasive inspiratory effort indicators, and to compare characteristics of inspiratory effort in neurocritical and non-neurocritical patients.

Methods: This was a single-centre prospective observational study. We collected three non-invasive inspiratory effort indicators, pressure muscular index (PMI), the maximal negative swing of airway pressure during expiratory occlusion (ΔPocc), and the airway occlusion pressure during the first 100ms (P0.1). Cutoff values for these indicators derived from esophageal pressure-time product (PTPmus) were chosen for this study. The correlation and agreement of these indicators were analyzed using Spearman's rank correlation test and linear weighted Kappa analysis. Characteristics of PSV settings and inspiratory effort in neurocritical and non-neurocritical patients were compared.

Results: Ninety-seven patients were enrolled in this study. Correlation analysis showed a moderate correlation between PMI and ΔPocc (rho = -0.524, p < 0.001), ΔPocc and P0.1 (rho = 0.588, p < 0.001), while no correlation between PMI and P0.1 (rho = -0.140, p = 0.172). There was a moderate agreement between ΔPocc and P0.1 (k = 0.459, p < 0.001), a fair agreement between PMI and ΔPocc (k = 0.362, p < 0.001), but no agreement between PMI and P0.1 (k = 0.134, p = 0.072). The correlation of these indicators was similar in neurocritical patients compared with non-neurocritical patients, but agreement was poor.

Conclusion: The study showed that PMI and ΔPocc had moderate correlation and fair agreement, ΔPocc and P0.1 had moderate correlation and agreement, while PMI and P0.1 had no correlation and agreement.

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评估压力支持通气期间吸气力度的无创指标之间的一致性。

背景：在压力支持通气（PSV）过程中，无创指标在诊断高吸气力或低吸气力方面的准确性已经得到验证。然而，这些指标的相关性和一致性仍不清楚。本研究旨在探讨无创吸气力指标之间的相关性和一致性，并比较神经危重症和非神经危重症患者的吸气力特征。方法：这是一项单中心前瞻性观察研究。我们收集了3个无创吸气力指标，即压力肌指数（PMI）、呼气闭塞时气道压力最大负摆（ΔPocc）和前100ms气道闭塞压力（P0.1）。本研究选择了食道压力-时间乘积（PTPmus）得出的这些指标的截止值。采用Spearman’s秩相关检验和线性加权Kappa分析分析这些指标的相关性和一致性。比较神经危重症和非神经危重症患者PSV设置和吸气力的特点。结果：97例患者入组。相关分析显示PMI与ΔPocc （rho = -0.524, p < 0.001）、ΔPocc与P0.1 （rho = 0.588, p < 0.001）中度相关，PMI与P0.1无相关性（rho = -0.140, p = 0.172）。ΔPocc与P0.1有中等程度的一致性（k = 0.459, p < 0.001）， PMI与ΔPocc有相当程度的一致性（k = 0.362, p < 0.001）， PMI与P0.1无一致性（k = 0.134, p = 0.072）。与非神经危重症患者相比，这些指标的相关性相似，但一致性较差。结论：研究表明PMI与ΔPocc有中度相关且符合，ΔPocc与P0.1有中度相关且符合，PMI与P0.1无相关且符合。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Medicine Medicine-General Medicine

CiteScore

5.10

自引率

5.10%

发文量

3710

审稿时长

12 weeks

期刊介绍： Frontiers in Medicine publishes rigorously peer-reviewed research linking basic research to clinical practice and patient care, as well as translating scientific advances into new therapies and diagnostic tools. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. In addition to papers that provide a link between basic research and clinical practice, a particular emphasis is given to studies that are directly relevant to patient care. In this spirit, the journal publishes the latest research results and medical knowledge that facilitate the translation of scientific advances into new therapies or diagnostic tools. The full listing of the Specialty Sections represented by Frontiers in Medicine is as listed below. As well as the established medical disciplines, Frontiers in Medicine is launching new sections that together will facilitate - the use of patient-reported outcomes under real world conditions - the exploitation of big data and the use of novel information and communication tools in the assessment of new medicines - the scientific bases for guidelines and decisions from regulatory authorities - access to medicinal products and medical devices worldwide - addressing the grand health challenges around the world