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2 "Armele Dornelas de Andrade"
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Original Article
Agreement between two methods for assessment of maximal inspiratory pressure in patients weaning from mechanical ventilation
Emanuelle Olympia Silva Ribeiro, Rik Gosselink, Lizandra Eveline da Silva Moura, Raissa Farias Correia, Wagner Souza Leite, Maria das Graças Rodrigues de Araújo, Armele Dornelas de Andrade, Daniella Cunha Brandão, Shirley Lima Campos
Acute Crit Care. 2022;37(4):592-600.   Published online October 27, 2022
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AbstractAbstract PDF
Respiratory muscle strength in patients with an artificial airway is commonly assessed as the maximal inspiratory pressure (MIP) and is measured using analogue or digital manometers. Recently, new electronic loading devices have been proposed to measure respiratory muscle strength. This study evaluates the agreement between the MIPs measured by a digital manometer and those according to an electronic loading device in patients being weaned from mechanical ventilation. Methods: In this prospective study, the standard MIP was obtained using a protocol adapted from Marini, in which repetitive inspiratory efforts were performed against an occluded airway with a one-way valve and were recorded with a digital manometer for 40 seconds (MIPDM). The MIP measured using the electronic loading device (MIPELD) was obtained from repetitively tapered flow resistive inspirations sustained for at least 2 seconds during a 40-second test. The agreement between the results was verified by a Bland-Altman analysis. Results: A total of 39 subjects (17 men, 55.4±17.7 years) was enrolled. Although a strong correlation between MIPDM and MIPELD (R=0.73, P<0.001) was observed, the Bland-Altman analysis showed a high bias of –47.4 (standard deviation, 22.3 cm H2O; 95% confidence interval, –54.7 to –40.2 cm H2O). Conclusions: The protocol of repetitively tapering flow resistive inspirations to measure the MIP with the electronic loading device is not in agreement with the standard protocol using one-way valve inspiratory occlusion when applied in poorly cooperative patients being weaned from mechanical ventilation.
Images in Critical Care
Real-time distinct visualization of barotrauma risk monitored by electrical impedance tomography in a COVID-19 and latent tuberculosis case
Wagner Souza Leite, Shirley Lima Campos, Daniella Cunha Brandão, Caio César Araújo Morais, Armèle Dornelas de Andrade
Acute Crit Care. 2022;37(4):672-673.   Published online September 21, 2022
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Citations to this article as recorded by  
  • Clinical Applicability of Electrical Impedance Tomography in Patient-Tailored Ventilation: A Narrative Review
    Serge J. H. Heines, Tobias H. Becher, Iwan C. C. van der Horst, Dennis C. J. J. Bergmans
    Tomography.2023; 9(5): 1903.     CrossRef

ACC : Acute and Critical Care