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Effectiveness of P0.1 in Determining the Timing of Mechanical Ventilation Weaning: A Diagnostic Meta-Analysis

Research Project

Project/Area Number 20K23222
Research Category

Grant-in-Aid for Research Activity Start-up

Allocation TypeMulti-year Fund
Review Section 0908:Society medicine, nursing, and related fields
Research InstitutionNagoya University

Principal Investigator

Nishida Kazuki  名古屋大学, 医学部附属病院, 病院助教 (30877072)

Project Period (FY) 2020-09-11 – 2023-03-31
Project Status Completed (Fiscal Year 2022)
Budget Amount *help
¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
Fiscal Year 2021: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2020: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Keywords重症呼吸不全 / 人工呼吸器 / ウイニング / 気道閉塞圧(P0.1) / 診断メタアナリシス / 診断オッズ比 / メタアナリシス
Outline of Research at the Start

重症呼吸不全では、人工呼吸器による治療が必須である。人工呼吸器の治療期間が適切でない場合、人工呼吸器装着による合併症のリスクが増えるが、人工呼吸器の離脱(ウイニング)の可否を予測する指標はまだ確立されていない。100ミリ秒の気道閉塞圧(P0.1)は人工呼吸器の治療下で容易に取得することができ、ウイニングの予測指標になりうるかどうか、いくつか検討されてきた。本研究では、ウイニングに対するP0.1の診断能力をメタアナリシスにより統合し、最適な閾値について提案することで、人工呼吸器の治療成績の向上に貢献したい。

Outline of Final Research Achievements

In the treatment of patients with severe respiratory failure, the appropriate use and timing of weaning from mechanical ventilation is crucial, yet an accurate predictive indicator has not been established. In response to this issue, we examined the efficacy of airway occlusion pressure (P0.1). P0.1 can be measured during treatment and could potentially predict the timing of weaning based on its threshold. However, as the threshold of P0.1 varies between studies, a clear decision criterion needs to be established. Thus, we conducted a diagnostic meta-analysis and evaluated its diagnostic power. As a result, we were able to show that P0.1 significantly predicts the possibility of weaning. This achievement is expected to contribute to improving the success rate of mechanical ventilation treatment.

Academic Significance and Societal Importance of the Research Achievements

重症呼吸不全患者にとって、人工呼吸器からの適切な離脱タイミングは、治療成果と患者の生命に直結する重要な課題である。しかしながら、離脱の最適なタイミングを予測する確立された指標は未確立である。この状況を改善すべく、我々は気道閉塞圧(P0.1)の診断的有効性を検討した。P0.1は人工呼吸器治療中に簡単に測定可能であり、離脱の可否を有意に予測することが判明した。この成果は人工呼吸器治療の成果向上という臨床現場での具体的な貢献のみならず、重症呼吸不全患者の生命維持と生活の質向上に対する社会的意義も大いに有する。我々の研究は、人工呼吸器からの離脱に関する決定的な評価指標の確立に貢献できたと考えている。

Report

(4 results)
  • 2022 Annual Research Report   Final Research Report ( PDF )
  • 2021 Research-status Report
  • 2020 Research-status Report
  • Research Products

    (5 results)

All 2022 2021

All Journal Article (5 results) (of which Int'l Joint Research: 2 results,  Peer Reviewed: 5 results,  Open Access: 2 results)

  • [Journal Article] Premorbid angiotensin converting enzyme inhibitors or angiotensin II receptor blockers in patients with sepsis2022

    • Author(s)
      Hasegawa Daisuke、Lee Young Im、Prasitlumkum Narut、Chopra Lakshay、Nishida Kazuki、Smith Robert L.、Sato Ryota
    • Journal Title

      The American Journal of Emergency Medicine

      Volume: 62 Pages: 69-77

    • DOI

      10.1016/j.ajem.2022.10.006

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Comparison of Bivalirudin Versus Heparin for Anticoagulation During Extracorporeal Membrane Oxygenation2022

    • Author(s)
      Hasegawa Daisuke、Sato Ryota、Prasitlumkum Narut、Nishida Kazuki、Keaton Brian、Acquah Samuel O.、Im Lee Young
    • Journal Title

      ASAIO Journal

      Volume: 69 Issue: 4 Pages: 396-401

    • DOI

      10.1097/mat.0000000000001814

    • Related Report
      2022 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Overexpression of KIAA1199, a novel strong hyaluronidase, is a poor prognostic factor in patients with osteosarcoma2021

    • Author(s)
      Ito Kan、Nishida Yoshihiro、Ikuta Kunihiro、Urakawa Hiroshi、Koike Hiroshi、Sakai Tomohisa、Zhang Jiarui、Shimoyama Yoshie、Imagama Shiro
    • Journal Title

      Journal of Orthopaedic Surgery and Research

      Volume: 16 Issue: 1 Pages: 439-439

    • DOI

      10.1186/s13018-021-02590-4

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Prevalence of pulmonary embolism in patients with acute exacerbations of COPD: A systematic review and meta-analysis2021

    • Author(s)
      Sato Ryota、Hasegawa Daisuke、Nishida Kazuki、Takahashi Kunihiko、Schleicher Mary、Chaisson Neal
    • Journal Title

      The American Journal of Emergency Medicine

      Volume: 50 Pages: 606-617

    • DOI

      10.1016/j.ajem.2021.09.041

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] The predictive value of airway occlusion pressure at 100?msec (P0.1) on successful weaning from mechanical ventilation: A systematic review and meta-analysis2021

    • Author(s)
      Sato Ryota、Hasegawa Daisuke、Hamahata Natsumi T.、Narala Swetha、Nishida Kazuki、Takahashi Kunihiko、Sempokuya Tomoki、Daoud Ehab G.
    • Journal Title

      Journal of Critical Care

      Volume: 63 Pages: 124-132

    • DOI

      10.1016/j.jcrc.2020.09.030

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Int'l Joint Research

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Published: 2020-09-29   Modified: 2024-01-30  

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