Sonographic Assessment of The Impact of Heart Lung Interactions on Success of Weaning from Mechanical Ventilation

Sabry, Sherif; Saber, Hamdy M; El-Dehily, Khalaf; Omar, Mostafa A

doi:10.21608/jicem.2022.170632.1010

Sonographic Assessment of The Impact of Heart Lung Interactions on Success of Weaning from Mechanical Ventilation

Document Type : Original papers

Authors

¹ ِAssistant Professor of critical care medicine ,Critical care department ,Beni-Suef University,Beni-Suef ,Egypt

² Assistant professor critical care medicine -Critical care department -Faculty of medicine -Beni Suef University,Beni-Suef ,Egypt

³ lecturer critical care medicine,faculty of medicine ,Beni-Suef University,Beni-Suef ,Egypt

⁴ Assistant lecturer critical care medicine,faculty of medicine ,Beni-Suef University,Beni-Suef ,Egypt

10.21608/jicem.2022.170632.1010

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.

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