Mechanical Ventilation Complication Clinical Trial
Official title:
The Impact of Thoracic Fluid Content Measured by Cardiometry on Prediction of Failure of Weaning From Mechanical Ventilation
This study aims to test the accuracy of the total thoracic fluid content (TFC) measured by cardiometry can predict weaning failure. Area under receiver operating characteristic curve (AUROC) will be determined, sensitivity, specificity, and best cutoff value will be calculated for TFC in prediction of weaning failure.
Weaning from mechanical ventilation is a serious and challenging process in critical care
practice. Weaning failure is associated with poor patient outcomes. Increased mortality in
patients with failed weaning was due to development of complications related to
re-intubation. Detection and correction of the cause of failed spontaneous breathing trial
(SBT) helps the intensives to improve the outcome of the next trials.
Fluid overload and positive cumulative fluid balance is a risk factor of weaning failure in
both cardiac and non-cardiac patients.
Many tools for prediction of lung congestion as a risk factor for weaning failure have been
reported. The gold standard for detection of cardiac cause of weaning failure was pulmonary
artery catheter. More simple tools had been investigated for detection of cardiac cause of
weaning failure in patients with or without previous cardiac dysfunction such as
extravascular lung water and B-natriuretic peptide (BNP) levels.
Although measurement of extravascular lung water is a reliable tool for prediction of cardiac
cause of weaning failure, it has the disadvantage of the need of advanced monitor with
invasive arterial line. Bioreactance is a new technology used for measurement of cardiac
output and total thoracic fluid content (TFC). More recently, electrical velocimetry is a
newer technology with good performance in cardiac output monitoring. The use of electrical
velocimetry in measurement of TFC has the advantage of being non-invasive with no need for
advanced skills. The aim of this work is to validate the use of TFC (measured by electrical
velocimetry) in prediction of weaning outcome.
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