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Thoracic fluid content: a novel parameter for predicting failed weaning from mechanical ventilation.

Shymaa Fathy1, Ahmed M Hasanin1, Mohamed Raafat1

  • 1Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Cairo University, 01 Elsarayah Street, Elmanyal, Cairo, 11559 Egypt.

Journal of Intensive Care
|March 13, 2020
PubMed
Summary

Thoracic fluid content (TFC) moderately predicts weaning outcomes in surgical ICU patients. In patients with low ejection fraction (<40%), TFC > 50 kΩ⁻¹ excellently predicts weaning failure.

Keywords:
Electrical cardiometryImpaired cardiac contractilityMechanical ventilationThoracic fluid contentWeaning

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Area of Science:

  • Critical Care Medicine
  • Pulmonary Medicine
  • Cardiovascular Medicine

Background:

  • Mechanical ventilation weaning is a critical ICU decision.
  • Accurate prediction of weaning success is essential for patient outcomes.
  • Thoracic fluid content (TFC) is a potential, non-invasive predictor.

Purpose of the Study:

  • To evaluate the accuracy of TFC as a predictor of weaning success in critically ill surgical patients.
  • To assess TFC's predictive ability in different patient subgroups.

Main Methods:

  • Observational cohort study of 64 extubation-eligible surgical ICU patients.
  • TFC measured using electrical cardiometry before spontaneous breathing trial.
  • Receiver operating characteristic (ROC) curve analysis to determine predictive accuracy.

Main Results:

  • 41/64 (64%) patients were successfully weaned.
  • TFC was significantly higher in the failed weaning group (p<0.05).
  • TFC showed moderate predictive ability (AUC 0.69) for weaning failure; excellent in patients with ejection fraction < 40% (AUC 0.93).

Conclusions:

  • TFC demonstrates moderate predictive accuracy for weaning outcomes in surgical ICU patients.
  • TFC > 50 kΩ⁻¹ is an excellent predictor of weaning failure in patients with ejection fraction < 40%.