Chest Ultrasound in Predication of Weaning Failure

Authors

  • Soliman Belal Soliman Critical Care Medicine Department, Cairo University, Cairo, Egypt
  • Faheem Ragab Critical Care Medicine Department, Cairo University, Cairo, Egypt
  • Randa Aly Soliman Critical Care Medicine Department, Cairo University, Cairo, Egypt
  • Ayman Gaber Critical Care Medicine Department, Cairo University, Cairo, Egypt
  • Ahmed Kamal Critical Care Medicine Department, Cairo University, Cairo, Egypt

DOI:

https://doi.org/10.3889/oamjms.2019.277

Keywords:

mechanical ventilation, chest ultrasonography, Doppler tissue imaging, lung ultrasound

Abstract

AIM: Failure of weaning from mechanical ventilation (MV) is a common problem that faces the intensivist despite having some prediction indices. Application of chest ultrasonography (US) may help in weaning and prediction of its outcome.

METHODS: 100 patients on invasive MV fulfilling criteria of weaning shifted to spontaneous breathing trial (SBT) (using PSV 8 cm H2O) for 1 hour. Weaning failure was defined as; Failed SBT, reintubation and/or ventilation or death within 48 hours. Echocardiography was used to get Ejection fraction, E/A ratio, Doppler tissue imaging (DTI) &, lung ultrasound (LUS) was used to assess LUS score, diaphragm ultrasound was used to assess diaphragmatic thickening fraction (DTF).

RESULTS: Mean age 57.1 ± 14.5, 62% were males. Weaning was successful in 80% of patients. LUS score was significantly higher in the failed weaning group: (10.8 ± 4.2) vs (16.5 ± 4.2 cm), (p: 0.001). (DTF) Was significantly higher in the successful weaning group: (43.0 ± 10.7) vs (28.9 ± 2.8 cm), (p: 0.001). DTF can predict successful weaning using Receiver operating characteristic (ROC) curves with the cutoff value: ≥ 29.5 with sensitivity 88.0% and specificity 80.0% with a p-value ˂ 0.001.LUS score can predict weaning failure by using a ROC curve with cutoff value: ≥ 15.5 with sensitivity 70.0% and specificity 82.5 % with a p-value ˂ 0.001.)

CONCLUSION: The use of bedside chest US (to assess lung and diaphragm) of great benefit throughout the weaning process.

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Published

2019-04-14

How to Cite

1.
Soliman SB, Ragab F, Soliman RA, Gaber A, Kamal A. Chest Ultrasound in Predication of Weaning Failure. Open Access Maced J Med Sci [Internet]. 2019 Apr. 14 [cited 2024 Jun. 17];7(7):1143-7. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2019.277

Issue

Section

B - Clinical Sciences