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Left Ventricular Overloading Identified by Critical Care Echocardiography Is Key in Weaning-induced Pulmonary Edema by Marine Goudelin; Pauline Champy; Jean-Bernard Amiel; Bruno Evrard; Anne-Laure Fedou; Thomas Daix; Bruno François; Philippe Vignon is a Medicine article available to read on EtoBox.

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## 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 who developed wipo. sbt-induced central hemodynamic changes were more pronounced in patients who developed wipo, with higher e wave velocity (122 cm/s [92; 159] vs. 93 cm/s [74; 109]: p = 0.017) and e/a ratio (2.1 [1.2; 3.6] vs. 0.9 [0.8; 1.4]: p = 0.001), and shorter e wave deceleration time (85 ms [72; 125] vs. 147 ms [103; 175]: p = 0.004). after echocardiography-guided treatment, all patients who failed

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Author

Marine Goudelin; Pauline Champy; Jean-Bernard Amiel; Bruno Evrard; Anne-Laure Fedou; Thomas Daix; Bruno François; Philippe Vignon

Publisher

Springer; Springer-Verlag; Springer Verlag; Springer Science and Business Media LLC (ISSN 1432-1238)

Published

2020

Language

EN

Field

Medicine (Health Sciences)