Coinciding Changes in B Lines Patterns, Haemoglobin and Hematocrit Values Can Predict Outcomes of Weaning from Mechanical Ventilation

Abstract

BACKGROUND: Weaning from invasive mechanical ventilation (MV) is considered as a daily challenging practice in the management of critically ill patients. The use of lung ultrasound and change in haemoglobin and hematocrit during weaning may help to predict weaning outcomes.

AIM: We aimed in our study to make a focused view over the changes occurred in lungs during weaning from MV which were detected by lung ultrasound through increase in B lines with the occurrence of weaning induced pulmonary oedema (WIPE), coinciding with this changes the occurrence of hemoconcentration was detected through increase in Hb and HCT values after SBT.

PATIENTS AND METHODS: Sixty patients who fulfilled readiness criteria for weaning from MV. Spontaneous breathing trial (SBT) on T-piece for 120 minutes was performed under close hemodynamic monitoring. Lung ultrasound was performed using eight lung zones protocol to detect both the presence and the trend of change in B lines before and after SBT. For all the studied patients, haemoglobin and hematocrit values were checked just before and at the end of SBT.

RESULTS: Patient who failed to pass SBT showed significant increase in lung segments showing B pattern, haemoglobin and hematocrit levels (p-value < 0.001 for all) also those patients had significantly higher duration of ICU stay (p-value < 0.001) Despite mortality rate was higher among patients who failed SBT yet it was statistically insignificant (p-value 0.104).

CONCLUSION: lung ultrasound and both haemoglobin and hematocrit levels correlate with weaning outcomes.