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العنوان
The Use of Lung Ultrasound in the Diagnosis of Weaning‑Induced Pulmonary Oedema in Mechanically Ventilated Patients/
المؤلف
Abd ElGileel,Mohammed Atef Mohammed
هيئة الاعداد
باحث / محمد عاطف محمد عبد الجليل
مشرف / ضياء عبد الخالق عقل
مشرف / منى رفعت حسنى
مشرف / أحمد عبد الدايم عبد الحق
تاريخ النشر
2021
عدد الصفحات
198.p:
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
التخدير و علاج الألم
تاريخ الإجازة
1/1/2021
مكان الإجازة
جامعة عين شمس - كلية الطب - Intensive Care
الفهرس
Only 14 pages are availabe for public view

from 196

from 196

Abstract

Background: Studies dealing with the use of lung ultrasound in the context of weaning have rather calculated lung ultrasound scores with aeration loss (without specifically addressing the issue of weaning induced pulmonary oedema “WIPO”) or assessed post-extubation distress. Our study specifically focuses on WIPO. Advantages of lung ultrasound for diagnosing WIPO are numerous. It provides a non-invasive and direct assessment of lung water accumulation by detecting lung interstitial syndrome (the first stage of haemodynamic pulmonary oedema), lung ultrasound is easier to learn and perform compared to Doppler echocardiography and the acquisition and analysis can be performed within 2 min.
Objective: To test the ideal profile (increase in the number of B-lines) for diagnosing WIPO using lung ultrasound to avoid the poor outcome of weaning failure.
Patients and Methods: This study was performed in intensive care units of Ain Shams University hospitals between October 2020 and March 2021. This study was carried out on 51 patients, the final outcome divided this group into three subgroups, successful group include 28 patients (54.9%), failed group without WIPO include 10 patients (19.6%) and failed group with WIPO include 13 patients (25.5%).
Results: The sensitivity of B-line in predict the successful weaning was 95.0, while the specificity was 90.0% and the accuracy was 92.0% at cut off value 5.0. The sensitivity of B-line in predict the WIPO was 90.0, while the specificity was 84.0% and the accuracy was 87.0% at cut off value 5.5.
Conclusion: from the results of this study it was concluded that an increase in the number of B-lines ≥ 5 on four anterior points during SBT provided the best accuracy for diagnosing WIPO with lung ultrasound. We suggest calling this sign the WIPO profile. These encouraging results must be confirmed by larger series, so that LUCI may empower the non-invasive monitoring tools, including biochemical indices, for the diagnosis of this common problem.