Weaning Outcome is Associated with ELWI and Impaired Diastolic Function
Article Category: Research Article
Data publikacji: 30 sty 2024
Zakres stron: 64 - 72
Otrzymano: 27 kwi 2023
Przyjęty: 29 paź 2023
DOI: https://doi.org/10.2478/jccm-2024-0008
Słowa kluczowe
© 2024 Dimitra Bagka et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Objectives
To evaluate hemodynamic profiles of critical care patients undergoing spontaneous t-piece trial (SBT) and present weaning failure.
Methods
Prospective observational study conducted in ready-to-wean non-cardiac ICU patients. Clinical, echocardiographic and thermodilution-derived variables were recorded before and after a 2-hour SBT. Weaning from mechanical ventilation was defined as preservation of spontaneous breathing for 48 hours following successful SBT.
Results
Fourteen patients succeeded weaning, five manifested T-trial-failure and six late-failure. Weaning outcome was significantly associated with ELWI(Extravascular lung-water index), global-end-diastolic index and impaired diastolic function, as indicated by pre-T Doppler early wave velocities (E/Em); Fifty-six percent of participants presented ELWI≥7mL/kg when fulfilling predetermined criteria for weaning. ELWI, impaired pulmonary permeability and left ventricular diastolic dysfunction were independent determinants of ELWI.
Conclusions
ELWI before SBT and impaired diastolic function (as indicated by pre-T E/Em) might be weaning outcome determinants and their assessment may allow better risk stratification in weaning decision making.