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Weaning management in a patient with heart dysfunction: a case report.
Haobo Jiang1, Meiling Lao1, Weixian Xu1
1Department of Critical Care Medicine of Foshan Hospital of Traditional Chinese Medicine, Foshan, China.
Frontiers in Physiology
|June 18, 2025
Summary
Spontaneous breathing trials (SBTs) can help identify extubation readiness. A T-piece (SBT-T) approach revealed weaning-induced pulmonary edema (WIPO) in a patient, allowing for successful management and extubation.
Area of Science:
- Critical Care Medicine
- Respiratory Therapy
Background:
- Mechanical ventilation weaning carries reintubation risks.
- Spontaneous breathing trials (SBTs), including T-piece (SBT-T) and pressure support (SBT-P), assess extubation readiness.
- Weaning-induced pulmonary edema (WIPO) is a frequent complication post-extubation, potentially leading to failure.
Observation:
- A patient failed extubation after a successful SBT-P due to WIPO.
- SBT-T was employed for the second weaning attempt.
- WIPO signs reappeared during SBT-T, prompting intensive monitoring and management.
Findings:
- The patient was successfully extubated during the second weaning attempt after targeted interventions.
- SBT-T effectively unmasked WIPO risk in a patient with cardiac dysfunction.
Implications:
- SBT-T can be valuable for identifying WIPO risk in high-risk patients.
- Proactive management during SBT-T may improve safety for patients with cardiac dysfunction during weaning.
- This case suggests a potential role for SBT-T in managing complex weaning scenarios.
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