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.