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148959

SONOGRAPHIC EVALUATION OF THE HEART, LUNG AND DIAPHRAGM DURING WEANING FROM MECHANICALLY VENTILATED CRITICALLY ILL PATIENTS

Article

Last updated: 26 Dec 2024

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Abstract

Background: Failure of weaning is a commonly encountered problem that faces intensivists, unfortunately this is a multifactorial condition and includes multiple interplays between cardiac and pulmonary functions. Timing is critical when determining if a patient can be successfully extubated. Premature discontinuation of mechanical ventilation may lead to increased cardiovascular and respiratory stress, CO2 retention and hypoxemia with up to 25% of patients requiring reinstitution of ventilator support. Unnecessary delays in weaning from mechanical ventilation also can be deleterious. Aim of work: To evaluate the value of echo, lung ultrasound and diaphragm ultrasound as a predictor of weaning outcomes compared to clinical weaning criteria. Patients and methods: Fifty patients were involved in the present study. They were admitted in the ICU at a tertiary hospital. They received the conventional measurements for weaning and echo, lung ultrasonography diaphragm ultrasonography during weaning and after extubation. We assessed the TAPSE, EF, E/A ratio, lung score, diaphragm excursion and thickening. All ultrasonography findings were gathered and compared with some of the usual clinical weaning tools such as arterial blood gas and respiratory mechanics. The findings were statistically analyzed. Results:31 patients were successfully weaned from mechanical ventilation according to the study criteria representing 62% and 19 patients failed weaning from mechanical ventilation representing 38%. Lung ultrasound and diaphragm thickening fraction only found to be significantly accurate predictors of weaning success or failure.
Conclusion: lung ultrasound score and diaphragm thickening fraction can be used as predictors of weaning outcomes.

DOI

10.21608/asmj.2020.148959

Keywords

sonography, heart, lung, Diaphragm, Mechanical Ventilation, Critical Ill Patients, Weaning

Authors

First Name

Nahed

Last Name

Youssef

MiddleName

E.

Affiliation

Department of Anesthesia and Intensive Care medicine Faculty of Medicine-Ain Shams University

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City

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Orcid

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First Name

Adel

Last Name

Alansary

MiddleName

M.

Affiliation

Department of Anesthesia and Intensive Care medicine Faculty of Medicine-Ain Shams University

Email

-

City

-

Orcid

-

First Name

Adel

Last Name

Habib

MiddleName

A.

Affiliation

Intensive Care Registrar at Dar Al Fouad Hospotal, Egypt

Email

-

City

-

Orcid

-

First Name

Fady

Last Name

Guirguis

MiddleName

N.

Affiliation

Department of Anesthesia and Intensive Care medicine Faculty of Medicine-Ain Shams University

Email

-

City

-

Orcid

-

Volume

71

Article Issue

4

Related Issue

21898

Issue Date

2020-12-01

Receive Date

2021-02-16

Publish Date

2020-12-01

Page Start

1,009

Page End

1,018

Print ISSN

0002-2144

Online ISSN

2735-3540

Link

https://asmj.journals.ekb.eg/article_148959.html

Detail API

https://asmj.journals.ekb.eg/service?article_code=148959

Order

17

Type

Original Article

Type Code

1,311

Publication Type

Journal

Publication Title

Ain Shams Medical Journal

Publication Link

https://asmj.journals.ekb.eg/

MainTitle

SONOGRAPHIC EVALUATION OF THE HEART, LUNG AND DIAPHRAGM DURING WEANING FROM MECHANICALLY VENTILATED CRITICALLY ILL PATIENTS

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Article

Created At

22 Jan 2023