Coinciding Changes in B Lines Patterns, Haemoglobin and Hematocrit Values Can Predict Outcomes of Weaning from Mechanical Ventilation

Samir El Hadidy; Mohamed Saad; Rania El Hossany; Tarek El Gohary; Mohamed El Ghobashy

doi:10.3889/oamjms.2019.615

Coinciding Changes in B Lines Patterns, Haemoglobin and Hematocrit Values Can Predict Outcomes of Weaning from Mechanical Ventilation

Open Access Maced J Med Sci. 2019 Dec 13;7(23):4010-4014. doi: 10.3889/oamjms.2019.615. eCollection 2019 Dec 15.

Authors

Samir El Hadidy¹, Mohamed Saad¹, Rania El Hossany¹, Tarek El Gohary¹, Mohamed El Ghobashy²

Affiliations

¹ Critical Care Medicine Department, Cairo University Hospitals, Cairo, Egypt.
² Radiology Department, Cairo University, Cairo, Egypt.

Abstract

Background: Weaning from invasive mechanical ventilation (MV) is considered as a daily challenging practice in the management of critically ill patients. The use of lung ultrasound and change in haemoglobin and hematocrit during weaning may help to predict weaning outcomes.

Aim: We aim to study the impact of weaning induced pulmonary edema on outcomes of weaning from mechanical ventilation.

Patients and methods: Sixty patients who fulfilled readiness criteria for weaning from MV. Spontaneous breathing trial (SBT) on T-piece for 120 minutes was performed under close hemodynamic monitoring. Lung ultrasound was performed using eight lung zones protocol to detect both the presence and the trend of change in B lines before and after SBT. For all the studied patients, haemoglobin and hematocrit values were checked just before and at the end of SBT.

Results: Patient who failed to pass SBT showed significant increase in lung segments showing B pattern, haemoglobin and hematocrit levels (p-value < 0.001 for all) also those patients had significantly higher duration of ICU stay (p-value < 0.001) Despite mortality rate was higher among patients who failed SBT yet it was statistically insignificant (p-value 0.104).

Conclusion: lung ultrasound and both haemoglobin and hematocrit levels correlate with weaning outcomes.

Keywords: B lines; Haemoglobin; Hematocrit; Lung ultrasound; Mechanical ventilation; Spontaneous breathing trials; Weaning.

Copyright: © 2019 Mahmoud Khaled Nour, Hany Tawfik Fathelbab, Ahmad Hosam Mwafy, Mohamad Ashraf Shawky, Santiago Jesús Camacho Freire, Javier León Jiménez, Jessica Roa Garrido, Antonio Enrique Gómez Menchero, Rosa Cardenal Piris, José Francisco Díaz Fernández, Samir ELhadidy Tawfik.