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Published on: June 12, 2021
Myocardial ischemia during ventilator weaning: a prospective multicenter cohort study
Alexandre Bedet1,2, Françoise Tomberli3, Gwenael Prat4
1Medical Intensive Care Unit, DHU A-TVB, Henri Mondor University Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, F-94010, France. alexandre.bedet@gmail.com.
Weaning-induced cardiac pulmonary edema is common in patients failing mechanical ventilation weaning. However, weaning-induced cardiac ischemia showed a weak association with this edema and did not impact weaning outcomes.
Area of Science:
- Critical Care Medicine
- Cardiology
- Pulmonary Medicine
Background:
- Weaning-induced cardiac pulmonary edema (WiPO) is a known cause of weaning failure.
- The role of weaning-induced cardiac ischemia (WiCI) in this process was investigated.
Purpose of the Study:
- To explore the mechanisms of weaning failure in mechanically ventilated patients.
- To determine the association between WiPO, WiCI, and weaning outcomes.
Main Methods:
- Prospective cohort study of patients failing a spontaneous breathing trial (SBT).
- Utilized echocardiography, ST monitoring, and biomarkers to assess WiPO and WiCI.
- Defined WiPO and WiCI based on established criteria.
Main Results:
- WiPO occurred frequently (59.6% liberal, 21.2% conservative definition).
- WiCI was diagnosed in 20.3% (ESC) and 6.8% (AHA) of patients.
- WiCI was not associated with WiPO or weaning outcomes.
Conclusions:
- Pulmonary edema is common in patients failing SBT.
- The link between cardiac ischemia and weaning failure appears weak in this context.
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