ArticleIntensive care medicine2020
Left ventricular overloading identified by critical care echocardiography is key in weaning-induced pulmonary edema.
Article in Intensive care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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20 citing papers in PubMed, 47 citations in OpenAlex.
- Effect of Flow Rates of High-Flow Nasal Cannula on Extubation Outcomes: A Randomized Controlled Trial.Chest · 2025Trial
- A Randomized Controlled Clinical Trial Investigating the Weaning Process From Mechanical Ventilation in Elderly Patients With Dementia.The clinical respiratory journal · 2024Trial
- Integrated comprehensive assessment for predicting weaning success in difficult-to-wean critically ill patients: the WEAN-US study.Critical care (London, England) · 2026Observational
- Beyond the Spontaneous Breathing Trial: Echocardiographic and Integrated Ultrasound Assessment During Weaning from Mechanical Ventilation.Diagnostics (Basel, Switzerland) · 2026Review
- Modified Venous Excess Ultrasound (mVExUS) in the Prediction of Ventilator Weaning Failure: a Cohort Study.POCUS journal · 2026Article
- Norepinephrine use at extubation in critically ill patients with obesity: a cohort study with multicenter validation.Intensive care medicine · 2025Observational
- Thoracic fluid content by electrical cardiometry versus diaphragmatic excursion by ultrasound for the prediction of weaning success in patients with lung congestion.Acute and critical care · 2025Article
- Prediction of weaning outcomes from mechanical ventilation in critically ill patients based on the combination of ultrasound parameters of the heart, lung, and diaphragm: a prospective observational cohort study.Quantitative imaging in medicine and surgery · 2025Article
- Incidence and risk factors of weaning-induced pulmonary oedema: results from a multicentre, observational study.Critical care (London, England) · 2025Observational
- Heart-Lungs interactions: the basics and clinical implications.Annals of intensive care · 2024Review
- Continuous monitoring of left ventricular function in postoperative intensive care patients using artificial intelligence and transesophageal echocardiography.Intensive care medicine experimental · 2024Article
- Combined cardiac, lung, and diaphragm ultrasound for predicting weaning failure during spontaneous breathing trial.Annals of intensive care · 2024Article
- Speckle tracking ultrasound as a new tool to predict the weaning outcome of mechanical ventilation patients: a prospective observational study.Frontiers in medicine · 2024Article
- Tricuspid annular plane systolic excursion/mitral annular plane systolic excursion ratio in critically ill patients: an index of right- and left-ventricular function mismatch and a risk factor for cardiogenic pulmonary edema.BMC anesthesiology · 2023Observational
- Cardiopulmonary interactions during ventilator weaning.Frontiers in physiology · 2023Review
- Machines that save lives in the intensive care unit: the ultrasonography machine.Intensive care medicine · 2022Review
- Repeated endo-tracheal tube disconnection generates pulmonary edema in a model of volume overload: an experimental study.Critical care (London, England) · 2022Article
- High-flow nasal oxygen cannula vs. noninvasive mechanical ventilation to prevent reintubation in sepsis: a randomized controlled trial.Annals of intensive care · 2021Article
- Continuous cardiac output assessment or serial echocardiography during septic shock resuscitation?Annals of translational medicine · 2020Review
- The first 24-h negative fluid balance is related to lower short-term mortality but higher AKI progression in critically ill heart failure: a retrospective cohort study.Therapeutic advances in cardiovascular diseaseArticle
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8 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeTo assess the role of left ventricular overload and cumulated fluid balance in the development weaning-induced pulmonary edema (WIPO).
methodsVentilated patients in sinus rhythm with COPD and/or heart failure (ejection fraction ≤ 40%) were studied. Echocardiography was performed immediately before and during a 30-min spontaneous breathing trial (SBT) using a T-tube. Patients who failed were treated according to echocardiography results before undergoing a second SBT.
resultsTwelve of 59 patients failed SBT, all of them developing WIPO. Patients who succeeded SBT had lower body weight (- 2.5 kg [- 4.8; - 1] vs. + 0.75 kg [- 2.95; + 5.57]: p = 0.02) and cumulative fluid balance (- 2326 ml [- 3715; + 863] vs. + 143 ml [- 2654; + 4434]: p = 0.007) than those who developed WIPO. SBT-induced central hemodynamic changes were more pronounced in patients who developed WIPO, with higher E wave velocity (122 cm/s [92; 159] vs. 93 cm/s [74; 109]: p = 0.017) and E/A ratio (2.1 [1.2; 3.6] vs. 0.9 [0.8; 1.4]: p = 0.001), and shorter E wave deceleration time (85 ms [72; 125] vs. 147 ms [103; 175]: p = 0.004). After echocardiography-guided treatment, all patients who failed the first SBT were successfully extubated. Fluid balance was then negative (- 2224 ml [- 7056; + 100] vs. + 146 ml [- 2654; + 4434]: p = 0.005). Left ventricular filling pressures were lower (E/E': 7.3 [5; 10.4] vs. 8.9 [5.9; 13.1]: p = 0.028); SBT-induced increase in E wave velocity (+ 10.6% [- 2.7/ + 18] vs. + 25.6% [+ 12.7/ + 49]: p = 0.037) and of mitral regurgitation area were significantly smaller.
conclusionIn high-risk patients, WIPO appears related to overloaded left ventricle associated with excessive fluid balance. SBT-induced central hemodynamic changes monitored by CCE help in guiding therapy for successful weaning.
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