Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilation
Abstract Background Weaning of patients from the mechanical ventilation remains one of the critical decisions in intensive care unit. This study aimed to evaluate the accuracy of thoracic fluid content (TFC) as a predictor of weaning outcome. Methods An observational cohort study included 64 critica...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-03-01
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| Series: | Journal of Intensive Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40560-020-00439-2 |
| _version_ | 1811295887295512576 |
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| author | Shymaa Fathy Ahmed M. Hasanin Mohamed Raafat Maha M. A. Mostafa Ahmed M. Fetouh Mohamed Elsayed Esraa M. Badr Hanan M. Kamal Ahmed Z. Fouad |
| author_facet | Shymaa Fathy Ahmed M. Hasanin Mohamed Raafat Maha M. A. Mostafa Ahmed M. Fetouh Mohamed Elsayed Esraa M. Badr Hanan M. Kamal Ahmed Z. Fouad |
| author_sort | Shymaa Fathy |
| collection | DOAJ |
| description | Abstract Background Weaning of patients from the mechanical ventilation remains one of the critical decisions in intensive care unit. This study aimed to evaluate the accuracy of thoracic fluid content (TFC) as a predictor of weaning outcome. Methods An observational cohort study included 64 critically ill surgical patients who were eligible for extubation. Before initiating the spontaneous breathing trial, the TFC was measured using the electrical cardiometry technology. Patients were followed up after extubation and divided into successful weaning group and failed weaning group. Both groups were compared according to respiratory and cardiovascular parameters. Receiver operating characteristic (ROC) curves were constructed to evaluate the ability of TFC to predict weaning outcome. Results The number of successfully weaned patients was 41/64 (64%). Twenty (31%) patients had impaired cardiac contractility, and of them, 13/20 (64%) patients were successfully extubated. Both groups, successful weaning group and failed weaning group, were comparable in most of baseline characteristics; however, the TFC was significantly higher in the failed weaning group compared to the successful weaning group. The area under the ROC curves (AUCs) showed moderate predictive ability for the TFC in predicting weaning failure (AUC [95% confidence interval] 0.69 [0.57–0.8], cutoff value > 50 kΩ−1), while the predictive ability of TFC was excellent in the subgroup of patients with ejection fraction < 40% (AUC [95% confidence interval 0.93 [0.72–1], cutoff value > 50 kΩ−1). Conclusions Thoracic fluid content showed moderate ability for predicting weaning outcome in surgical critically ill patients. However, in the subgroup of patients with ejection fraction less than 40%, TFC above 50 kΩ−1 has an excellent ability to predict weaning failure. |
| first_indexed | 2024-04-13T05:40:16Z |
| format | Article |
| id | doaj.art-5e18851dd539482b8adca50a3f890b50 |
| institution | Directory Open Access Journal |
| issn | 2052-0492 |
| language | English |
| last_indexed | 2024-04-13T05:40:16Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Intensive Care |
| spelling | doaj.art-5e18851dd539482b8adca50a3f890b502022-12-22T03:00:07ZengBMCJournal of Intensive Care2052-04922020-03-01811710.1186/s40560-020-00439-2Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilationShymaa Fathy0Ahmed M. Hasanin1Mohamed Raafat2Maha M. A. Mostafa3Ahmed M. Fetouh4Mohamed Elsayed5Esraa M. Badr6Hanan M. Kamal7Ahmed Z. Fouad8Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo UniversityDepartment of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo UniversityAbstract Background Weaning of patients from the mechanical ventilation remains one of the critical decisions in intensive care unit. This study aimed to evaluate the accuracy of thoracic fluid content (TFC) as a predictor of weaning outcome. Methods An observational cohort study included 64 critically ill surgical patients who were eligible for extubation. Before initiating the spontaneous breathing trial, the TFC was measured using the electrical cardiometry technology. Patients were followed up after extubation and divided into successful weaning group and failed weaning group. Both groups were compared according to respiratory and cardiovascular parameters. Receiver operating characteristic (ROC) curves were constructed to evaluate the ability of TFC to predict weaning outcome. Results The number of successfully weaned patients was 41/64 (64%). Twenty (31%) patients had impaired cardiac contractility, and of them, 13/20 (64%) patients were successfully extubated. Both groups, successful weaning group and failed weaning group, were comparable in most of baseline characteristics; however, the TFC was significantly higher in the failed weaning group compared to the successful weaning group. The area under the ROC curves (AUCs) showed moderate predictive ability for the TFC in predicting weaning failure (AUC [95% confidence interval] 0.69 [0.57–0.8], cutoff value > 50 kΩ−1), while the predictive ability of TFC was excellent in the subgroup of patients with ejection fraction < 40% (AUC [95% confidence interval 0.93 [0.72–1], cutoff value > 50 kΩ−1). Conclusions Thoracic fluid content showed moderate ability for predicting weaning outcome in surgical critically ill patients. However, in the subgroup of patients with ejection fraction less than 40%, TFC above 50 kΩ−1 has an excellent ability to predict weaning failure.http://link.springer.com/article/10.1186/s40560-020-00439-2Thoracic fluid contentElectrical cardiometryWeaningMechanical ventilationImpaired cardiac contractility |
| spellingShingle | Shymaa Fathy Ahmed M. Hasanin Mohamed Raafat Maha M. A. Mostafa Ahmed M. Fetouh Mohamed Elsayed Esraa M. Badr Hanan M. Kamal Ahmed Z. Fouad Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilation Journal of Intensive Care Thoracic fluid content Electrical cardiometry Weaning Mechanical ventilation Impaired cardiac contractility |
| title | Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilation |
| title_full | Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilation |
| title_fullStr | Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilation |
| title_full_unstemmed | Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilation |
| title_short | Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilation |
| title_sort | thoracic fluid content a novel parameter for predicting failed weaning from mechanical ventilation |
| topic | Thoracic fluid content Electrical cardiometry Weaning Mechanical ventilation Impaired cardiac contractility |
| url | http://link.springer.com/article/10.1186/s40560-020-00439-2 |
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