Left ventricular overloading identified by critical care echocardiography is key in weaning-induced pulmonary edema.

ABSTRACT:

Purpose

To assess the role of left ventricular overload and cumulated fluid balance in the development weaning-induced pulmonary edema (WIPO).

Methods

Ventilated patients in sinus rhythm with COPD and/or heart failure (ejection fraction ≤ 40%) were studied. Echocardiography was performed immediately before and during a 30-min spontaneous breathing trial (SBT) using a T-tube. Patients who failed were treated according to echocardiography results before undergoing a second SBT.

Results

Twelve of 59 patients failed SBT, all of them developing WIPO. Patients who succeeded SBT had lower body weight (- 2.5 kg [- 4.8; - 1] vs. + 0.75 kg [- 2.95;  + 5.57]: p = 0.02) and cumulative fluid balance (- 2326 ml [- 3715;  + 863] vs. + 143 ml [- 2654; + 4434]: p = 0.007) than those w

SUBMITTER: Goudelin M 

PROVIDER: S-EPMC7223421 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature