Usefulness of Combined Bedside Lung Ultrasound and Echocardiography to Assess Weaning Failure From Mechanical Ventilation

Silvia Mongodi; Gabriele Via; Bélaïd Bouhemad; Enrico Storti; Francesco Mojoli; Antonio Braschi

doi:10.1097/ccm.0b013e31828e928d

July 18, 2013Critical Care Medicine

Usefulness of Combined Bedside Lung Ultrasound and Echocardiography to Assess Weaning Failure From Mechanical Ventilation

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Key Points

Describe the diagnostic utility of combined bedside lung ultrasound and echocardiography in identifying an unexpected cardiogenic cause for repeated mechanical ventilation weaning failure.
Single-case report evaluated an abdominal surgery postoperative patient in a university general intensive care unit undergoing difficult weaning.
Hemodynamic, respiratory, biochemistry, bedside lung ultrasound, and echocardiography datasets were captured across two spontaneous breathing trials.
Cardiovascular medical therapy was adapted according to imaging findings obtained during weaning trials.
Lung ultrasound at the end of the failed spontaneous breathing trial revealed diffuse, bilateral, symmetrical interstitial syndrome reflecting increased extravascular lung water, with concurrent echocardiography detecting left ventricular diastolic failure.
Following targeted cardiovascular therapy adjustments, ultrasound during a repeat breathing trial showed normalized lung patterns and improved echocardiographic parameters, leading to successful ICU discharge.

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Implication

Case report demonstrates left ventricular diastolic dysfunction causing mechanical ventilation weaning failure in an ICU surgical patient, highlighting ultrasound-guided management.

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Mongodi et al. (2013) studied this question.

synapsesocial.com/papers/6a9de8cbd765d31189acb029 https://doi.org/10.1097/ccm.0b013e31828e928d

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Usefulness of Combined Bedside Lung Ultrasound and Echocardiography to Assess Weaning Failure From Mechanical Ventilation

Key Points

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Implication

Discussion

Cite This Study

Usefulness of Combined Bedside Lung Ultrasound and Echocardiography to Assess Weaning Failure From Mechanical Ventilation

Key Points

No abstract yet

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Implication

Discussion

Cite This Study

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