Lung ultrasound allows the diagnosis of weaning-induced pulmonary oedema

Ferré, Alexis; Guillot, M.; Lichtenstein, Daniel A.; Mézière, Gilbert; Richard, Christian; Teboul, Jean–Louis; Monnet, Xavier

doi:10.1007/s00134-019-05573-6

Cited by 71 publications

(65 citation statements)

References 33 publications

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“…In a very recent study, lung ultrasound evaluating the delta-B-lines before and after SBT in the four anterior chest wall regions was shown to provide excellent correlation with successful weaning [36]. However, the shift from mechanical to spontaneous ventilation may alone justify the appearance of such artifacts.…”

Section: The (He)art Of Weaning From Mechanical Ventilationmentioning

confidence: 99%

Mechanical ventilation weaning issues can be counted on the fingers of just one hand: part 1

et al. 2020

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Although mechanical ventilation may be a patient's vital ally during acute illness, it can quickly transform into an enemy during chronic conditions. The weaning process is the fundamental phase that enables the resumption of physiological respiratory function; however, it is also associated with a number of life-threatening complications, and a large percentage of critically ill patients never achieve airway device removal or require the resumption of mechanical ventilation just a few days post-weaning. Indeed, the weaning process is, at present, more of an art than a science. As such, there is urgent need for novel contributions from the scientific literature to abate the growing rates of morbidity and mortality associated with weaning failure. The physician attempting to wean a patient must integrate clinical parameters and common-sense criteria. Numerous studies have striven to identify single predictive factors of weaning failure and sought to standardize the weaning process, but the results are characterized by remarkable heterogeneity. Despite the lack of benchmarks, it is clear that the analysis of respiratory function must include a detailed overview of the five situations described below rather than a single aspect. The purpose of this two-part review is to provide a comprehensive description of these situations to clarify the "arena" physicians are entering when weaning critically ill patients from mechanical ventilation. Publisher's NoteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Section: The (He)art Of Weaning From Mechanical Ventilationmentioning

confidence: 99%

Mechanical ventilation weaning issues can be counted on the fingers of just one hand: part 1

et al. 2020

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“…Ferrè et al investigated the utility of LUS to detect weaning-induced pulmonary oedema (WIPO) during 62 spontaneous breathing trials in 42 patients [3]. WIPO occurred in 17 cases, and all these patients failed extubation.…”

Section: Lung Ultrasoundmentioning

confidence: 99%

Focus on ultrasound in intensive care

2020

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Over the past two decades, the amount of literature on point of care ultrasound (PoCUS) has been increasing rapidly. Nowadays, a growing body of evidence strongly supports its role in several fields with particular interest to the acute care settings. This article will review some recent literature that may be of interest to the critical care community. Our literature review mainly focuses on thoracic PoCUS, including eight articles on lung ultrasound (LUS), six articles on echocardiography and one article on diaphragm ultrasound. We also cite an important review on brain ultrasound, one article on multiorgan PoCUS and two articles on procedure guidance.

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“…We would like to discuss several factors potentially affecting the results of lung ultrasonography when used to diagnose weaning-induced pulmonary oedema (WIPO), as described in a recent issue of Intensive Care Medicine [1].…”

Section: Dear Editormentioning

confidence: 99%

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confidence: 99%

Is lung ultrasonography really useful for diagnosing weaning-induced pulmonary oedema?

2019

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Dear Editor,We would like to discuss several factors potentially affecting the results of lung ultrasonography when used to diagnose weaning-induced pulmonary oedema (WIPO), as described in a recent issue of Intensive Care Medicine [1].First, although the authors showed no significant differences in the baseline characteristics between patients with and without WIPO, several potential factors associated with WIPO were lacking in the discussion. The authors observed more B-lines before a spontaneous breathing trial (SBT) (5 ± 5 vs. 3 ± 3, P = 0.01) in the WIPO patients than in those without WIPO, suggesting higher hydrostatic pressure in the WIPO group. It would have been helpful to have a plausible explanation for this difference (e.g., a positive fluid balance could be a risk factor for weaning failure [2]). Moreover, pre-SBT ventilator settings, especially those of positive end-expiratory pressure, could have affected a changing breathing workload and intrathoracic pressure during SBT [3].Second, we wish the authors had provided data concerning the treatment, including diuretics, during the SBT trial. It is of great interest whether such weaning failures were potentially treatable.Finally, it is questionable whether it is indeed easy and reproducible to accurately determine that B-lines in WIPO patients are increased. Multiple B-lines could move rapidly with lung sliding signs due to tachypnoea, which might have caused large variation in the number of B-lines, according to the operators. Although it may be easy and non-invasive to perform lung ultrasonography, the reproducibility of B-line detection among operators requires discussion.

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Lung ultrasound allows the diagnosis of weaning-induced pulmonary oedema

Cited by 71 publications

References 33 publications

Mechanical ventilation weaning issues can be counted on the fingers of just one hand: part 1

Mechanical ventilation weaning issues can be counted on the fingers of just one hand: part 1

Focus on ultrasound in intensive care

Is lung ultrasonography really useful for diagnosing weaning-induced pulmonary oedema?

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