Applicability of Lung Ultrasound During Weaning From Mechanical Ventilation: A Systematic Review

Lung ultrasound (LUS) is increasingly used in the Intensive Care Unit (ICU) setting. However, its actual role in supporting the weaning process from mechanical ventilation remains uncertain as the ideal timing for extubation is still difficult to determine. This study aimed to review the use of lung ultrasound as a potential predictor of weaning from artificial ventilation.

This is a systematic review conducted using the PECOS strategy with searches in the PubMed, CENTRAL, LILACS, CINAHL and Cochrane databases using the descriptors mechanical ventilation, artificial ventilation, extubation, lung ultrasound, thoracic ultrasound and weaning combined with the Boolean operators AND OR.

Fourteen articles were identified after full-text reading. Among them, four studies suggested that lung ultrasound may be useful in aiding weaning, three reported limited accuracy in predicting extubation outcomes, and one was inconclusive. Different protocols were applied, such as LUS (six regions), modified LUSm, and the BLUE protocol. Reported sensitivity ranged from 66% to 97%-100% and specificity from 37.4% to 96%.

The included studies applied heterogeneous methodologies and cut-off values for sensitivity and specificity, limiting direct comparison and generalization. Despite these differences, findings suggest that lung ultrasound shows potential as an adjunctive tool in predicting weaning outcomes, although further standardized research is needed to clarify its clinical applicability.