Sonographic Assessment of The Impact of Heart Lung Interactions on Success of Weaning from Mechanical Ventilation | ||||
The Egyptian Journal of Intensive Care and Emergency Medicine | ||||
Volume 2, Issue 2, December 2022, Page 1-20 PDF (407.03 K) | ||||
Document Type: Original papers | ||||
DOI: 10.21608/jicem.2022.170632.1010 | ||||
View on SCiNiTO | ||||
Authors | ||||
Sherif Sabry 1; Hamdy M Saber2; khalaf El-Dehily3; Mostafa A Omar 4 | ||||
1ِAssistant Professor of critical care medicine ,Critical care department ,Beni-Suef University,Beni-Suef ,Egypt | ||||
2Assistant professor critical care medicine -Critical care department -Faculty of medicine -Beni Suef University,Beni-Suef ,Egypt | ||||
3lecturer critical care medicine,faculty of medicine ,Beni-Suef University,Beni-Suef ,Egypt | ||||
4Assistant lecturer critical care medicine,faculty of medicine ,Beni-Suef University,Beni-Suef ,Egypt | ||||
Abstract | ||||
Objective: Evaluation of lung ultrasound and echocardiography in weaning induced lung congestion and its impact on the weaning outcome. Background:Ultrasound can detect lung edema during weaning due to increased cardiac filling pressures Patients and Methods:prospective study that included 40 critically ill ventilated patients ready for weaning as per readiness criteria. Eligible ptns performed echocardiography,lung ultrasonography& serum NT-proBNP. Results: Forty-patients were included. Weaning failure was 57.5% (n =23 patients); of them,14 patients (35%) had the failure during the SBT. A statistically significant difference was found between each of lung ultrasound score (LUS) during PPV &SBT and weaning results (P = 0.006 and 0.026) respectively. A cut off value of 5.5 for LUS during PPV predicted weaning failure at sensitivity of 73.9% and specificity of 64.7 % (AUC=0.752). A cut off value of 5.5 for LUS during SBT predicted failure of weaning with a sensitivity of 73.9% and specificity of 64.7% (AUC=0.698).No significant difference was found for NT-proBNP measurements between failed&successful weaning groups. Echocardiographic parameters, E /e\ during PPV and SBT were higher in failed weaning group than successful weaning group (P = 0.005 and 0.002) respectively. A cut off value of 7.43 for E/e\ during PPV predicted weaning failure at sensitivity of 69.6% and a specificity of 64.7 % (AUC=0.762).Cut off value of 8 of E/e\ during SBT predicted weaning failure at a sensitivity of 82.6% and a specificity of 64.7% (AUC=0.793) Conclusions: Prediction of weaning failure using lung & cardiac U/S before start of weaning is safe. | ||||
Keywords | ||||
Spontaneous breathing trial; Mechanical ventilation; Ultrasonography; Weaning outcome | ||||
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