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Occlusion Pressure P0.1. Negative airway pressure generated during the first 100 ms of an occluded inspiration P0.1 values reflect neuromuscular activation of the patient during spontaneous breathing An indicator of whether a patient is ready to be weaned
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Negative airway pressure generated during the first 100 ms of an occluded inspiration P0.1 values reflect neuromuscular activation of the patient during spontaneous breathing An indicator of whether a patient is ready to be weaned Non-aggressive measure during non-forced inspiration Special Procedure
How Is It Measured? • P0.1 begins where the inspiratory valve remains closed during the first 100 ms of the next inspiratory cycle. • The airway pressure during the occlusion is measured by the ventilator´s pressure transducer in the expiratory limb just before the exhalation valve. • After measurement, the patient receives the set ventilatory support.
When a patient is under mandatory ventilation, the patient often becomes dependent on the ventilator and therefore it is difficult to begin weaning. P0.1 measurement is not recommended during mandatory ventilation because mandatory ventilation does not exercise patient musculatory drive Measurement of occlusion pressure when a patient spontaneously breathes helps the doctor accurately determine patient progress. This measurement helps to distinguish between a healthy and overexerted respiratory drive of a patient. Modes like ASB, BIPAP* and SIMV AutoFlowTM which enhance and support patient efforts are best for this measurement What conditions are optimal for this measurement? Mandatory Ventilation Spontaneous Breathing BIPAP* Trademark used under licence. AutoFlow™ Trademark of Drägerwerk AG.
Advantages * -6,0 mbar * patient hyperventilates * remains in hospital * -3,0 mbar * patient improves * leaves hospital Guided Diagnosis for Physician * -0,7 mbar * patient does not improve * remains in hospital Spontaneous Ability Controlled Ventilation (could climb a mountain) patient is weak patient is weak
Literature • "A new method for P0.1 measurement using standard respiratory equipment”; Kuhlen, Hausmann, et al • Clinical consequences of the Implementation of a weaning protocol* • Weaning Parameters to Detect Extubation Outcome* • Ventilatory Drive and Breathing Pattern for Predicting Outcome of a Weaning Trial* • f/Vt Ratio and P0.1 as Predictors of extubation outcome* *Source: Intensive Care Medicine Vol 22 #10, Supp.3
