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ORIGINAL ARTICLE
Year : 2020  |  Volume : 7  |  Issue : 2  |  Page : 211-219

Application of lung ultrasound for predicting outcome of weaning from mechanical ventilation


Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Ain Shams University, Abbasia, Cairo, Egypt

Correspondence Address:
Mona R Hosny
Department of Anesthesiology, Intensive Care, and Pain Management, Faculty of Medicine, Ain Shams University, Abbasia, Cairo 11566
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_16_19

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Background Weaning failure is an important issue among critically ill patients. Currently, lung ultrasound (US) is a useful tool to early predict this problem. This study was conducted to assess the efficacy of lung ultrasound to predict early weaning failure in critically ill patients. Patients and methods A total of 50 patients requiring mechanical ventilation (MV) were included in this prospective observational study. Patients were divided into two groups after 48 h: group NS included patients who were unsuccessfully weaned, either failed 30 min of spontaneous breathing trial (SBT) or reintubated within 24 h after being extubated, and group S included patients who were successfully weaned (extubated). Lung US was completed for all patients, 1 h before SBT while patients were mechanically ventilated, 30 min after SBT, and 6 h after extubation. Patients were prospectively followed up for the need for reintubation and mechanical ventilation or the need for non-invasive positive pressure ventilation (NIPPV) after successful extubation (primary endpoints). The length of Intensive care Unit (ICU) stay, duration of mechanical ventilation (MV) and ICU mortality (secondary end points). Results Lung US done for all patients in the anterior, lateral, and posterior regions of the lung showed significantly high lung US score in group NS than group S (P<0.001). The number of patients who failed SBT, needed reintubation and MV or noninvasive positive pressure ventilation, after being successfully extubated were significantly high in group NS than group S (P<0.001). During the study period, there were a significant decrease in ICU stay, ventilator days, and patient mortality in Group S than Group NS (P<0.001). Conclusions Lung US can accurately detect lung aeration changes and predict weaning outcome through estimating the lung US scoring system for lung aeration changes where high scores are associated with weaning failure.


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