Coinciding Changes in B Lines Patterns, Haemoglobin and Hematocrit Values Can Predict Outcomes of Weaning from Mechanical Ventilation.

BACKGROUND: Weaning from invasive mechanical ventilation (MV) is considered as a daily challenging practice in the management of critically ill patients. The use of lung ultrasound and change in haemoglobin and hematocrit during weaning may help to predict weaning outcomes.

AIM: We aim to study the impact of weaning induced pulmonary edema on outcomes of weaning from mechanical ventilation.

PATIENTS AND METHODS: Sixty patients who fulfilled readiness criteria for weaning from MV. Spontaneous breathing trial (SBT) on T-piece for 120 minutes was performed under close hemodynamic monitoring. Lung ultrasound was performed using eight lung zones protocol to detect both the presence and the trend of change in B lines before and after SBT. For all the studied patients, haemoglobin and hematocrit values were checked just before and at the end of SBT.

RESULTS: Patient who failed to pass SBT showed significant increase in lung segments showing B pattern, haemoglobin and hematocrit levels (p-value < 0.001 for all) also those patients had significantly higher duration of ICU stay (p-value < 0.001) Despite mortality rate was higher among patients who failed SBT yet it was statistically insignificant (p-value 0.104).

CONCLUSION: lung ultrasound and both haemoglobin and hematocrit levels correlate with weaning outcomes.