Transthoracic Echocardiography with Doppler Tissue Imaging predicts weaning failure from mechanical ventilation: evolution of the left ventricle relaxation rate during a spontaneous breathing trial is the key factor in weaning outcome.

Critical Care : the Official Journal of the Critical Care Forum
Sébastien MoschiettoGilles Bernardin

Abstract

There is growing evidence to suggest that transthoracic echocardiography (TTE) should be used to identify the cardiac origin of respiratory weaning failure. first, to evaluate the ability of transthoracic echocardiography, with mitral Doppler inflow E velocity to annular tissue Doppler Ea wave velocity (E/Ea) ratio measurement, to predict weaning failure from mechanical ventilation in patients, including those with atrial fibrillation; and second, to determine whether the depressed left ejection fraction and/or diastolic dysfunction participate in weaning outcome. The sample included patients on mechanical ventilation for over 48 hours. A complete echocardiography was performed just before the spontaneous breathing trial (SBT) and 10 minutes after starting the SBT. Systolic dysfunction was defined by a left ventricle ejection fraction under 50% and relaxation impairment by a protodiastolic annulus mitral velocity Ea under or equal to 8 cm/second. A total of 68 patients were included. Twenty failed the weaning process and the other 48 patients succeeded. Before the SBT, the E/Ea ratio was higher in the failed group than in the successful group. The E/Ea measured during the SBT was also higher in the failed group. The cut-off val...Continue Reading

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Citations

Jun 28, 2012·Critical Care : the Official Journal of the Critical Care Forum·Jérôme FichetFrédéric M Jacobs
Jul 10, 2012·Critical Care : the Official Journal of the Critical Care Forum·Gorazd Voga
Nov 26, 2013·Critical Care : the Official Journal of the Critical Care Forum·Daniel De Backer
Aug 28, 2014·Current Opinion in Critical Care·Martin DresXavier Monnet
May 28, 2014·Intensive Care Medicine·Jean-Louis Teboul
Dec 14, 2012·Current Opinion in Critical Care·Arnaud W ThilleAndrés Esteban
Apr 30, 2013·Current Opinion in Critical Care·Philippe Vignon
Sep 20, 2012·Critical Care Research and Practice·Jahan PorhomayonNader D Nader
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