Sonographic Assessment of The Impact of Heart Lung Interactions on Success of Weaning from Mechanical Ventilation
Sabry, S., Saber, H., El-Dehily, K., Omar, M. (2022). Sonographic Assessment of The Impact of Heart Lung Interactions on Success of Weaning from Mechanical Ventilation. EKB Journal Management System, 2(2), 1-20. doi: 10.21608/jicem.2022.170632.1010
Sherif Sabry; Hamdy M Saber; khalaf El-Dehily; Mostafa A Omar. "Sonographic Assessment of The Impact of Heart Lung Interactions on Success of Weaning from Mechanical Ventilation". EKB Journal Management System, 2, 2, 2022, 1-20. doi: 10.21608/jicem.2022.170632.1010
Sabry, S., Saber, H., El-Dehily, K., Omar, M. (2022). 'Sonographic Assessment of The Impact of Heart Lung Interactions on Success of Weaning from Mechanical Ventilation', EKB Journal Management System, 2(2), pp. 1-20. doi: 10.21608/jicem.2022.170632.1010
Sabry, S., Saber, H., El-Dehily, K., Omar, M. Sonographic Assessment of The Impact of Heart Lung Interactions on Success of Weaning from Mechanical Ventilation. EKB Journal Management System, 2022; 2(2): 1-20. doi: 10.21608/jicem.2022.170632.1010

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  XML PDF (407.03 K)
Document Type: Original papers
DOI: 10.21608/jicem.2022.170632.1010
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Authors
Sherif Sabry email 1; Hamdy M Saber2; khalaf El-Dehily3; Mostafa A Omarorcid 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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