Behavior of lung ultrasound findings during spontaneous breathing trial

Abstract

ObjectiveWe aimed to investigate a potential association between B-lines and weaning failure.MethodsFifty-seven subjects eligible for ventilation liberation were enrolled. Patients with tracheostomy were excluded. Lung ultrasound assessments of six thoracic zones were performed immediately before and at the exnd of the spontaneous breathing trial. B-predominance was defined as any profile with anterior bilateral B-pattern. Patients were followed up to 48 hours after extubation.ResultsThirty-eight individuals were successfully extubated; 11 failed the spontaneous breathing trial and 8 needed reintubation within 48 hours of extubation. At the beginning of the T-piece trial, B-pattern or consolidation was already found at the lower and posterior lung regions in more than half of the individuals and remained non-aerated at the end of the trial. A trend toward loss of lung aeration during spontaneous breathing trials was observed only in the spontaneous breathing trial-failure group (p = 0.07), and there was higher B-predominance at the end of the trial (p = 0.01).ConclusionA loss of lung aeration during the spontaneous breathing trial in non-dependent lung zones was demonstrated in subjects who failed to wean.

Role of lung ultrasound in weaning from mechanical ventilation in postoperative neurosurgical ICU patients

“…19 Lung aeration loss during SBT in non-dependent lung zones was demonstrated in subjects who failed to wean. 20 There were no studies on these ultrasound parameters collectively as a weaning predictor in comparison to traditional parameters. Previous studies were either focusing on every ultrasound parameter alone or using it as a diagnostic tool compared to other traditional or standard tool.…”

Lung Ultrasound: Just B Lines?

“…Second, the SBT technique utilized in this study (ie, pressure support with zero PEEP) is infrequently used in clinical practice, 5 so these results may have limited utility to clinical practice except for selected populations (eg, patients with COPD or congestive heart failure).…”

“…Because de-aeration found in lower lung regions implies gravitational changes after a few days on mechanical ventilation, 5 our simplified 4-zone approach seemed plausible for the purposes of our study. We did recognize that, based on our data, no inference could be made regarding either entire lung assessment or its integration with echocardiography.…”

Lung ultrasound score before and after extubation for predicting weaning outcome

“…Thus, assessing patients before and during SBT is very important to predict extubation failure. 2 Recently, LUS is introduced to assess lung abnormalities patterns. Bouhemad first proposed the LUS score for lung aeration patterns.…”