Prognostic value of different cardiac ultrasound indexes for weaning outcome of mechanical ventilation of respiratory failure in ICU
10.3760/cma.j.cn431274-20231122-00586
- VernacularTitle:不同心脏超声指标对ICU呼吸衰竭机械通气撤机结局的预测价值
- Author:
Bin YANG
1
;
Zhi DAI
;
Haijun XIAO
;
Na LI
;
Jing CHEN
Author Information
1. 中国人民解放军第九二一医院重症医学科，长沙 410003
- Keywords:
Echocardiography;
Respiratory insufficiency;
Ventilator weaning
- From:
Journal of Chinese Physician
2024;26(11):1664-1668
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the predictive value of different cardiac ultrasound indexes in mechanical ventilation withdrawal / weaning outcome of intensive care unit (ICU) respiratory failure.Methods:Patients who received mechanical ventilation for >48 hours and were to be withdrawn due to respiratory failure in the Department of Critical Care Medicine, 921st Hospital of the People′s Liberation Army from October 2020 to March 2023 were continuously selected, and their general information, mechanical ventilation conditions, and relevant weaning inspection indicators were recorded. Left ventricular ejection fraction (LVEF), left ventricular outflow tract velocity time integral (LVOT-VTI), left heart Tei index (TI), ratio of early mitral valve diastolic peak blood flow velocity to early mitral ring diastolic peak motion velocity (E/e′) were measured by ultrasound. According to the weaning outcome, the receiver operating characteristic (ROC) curves of different cardiac ultrasound indexes were plotted to evaluate the predictive value of the withdrawal outcome.Results:A total of 83 patients were included, of which 62 were successfully withdrawn and 21 were unsuccessful. There were significant differences in mechanical ventilation time, rapid shallow breathing index (RSBI), LVEF, VTI, left cardiac TI and E/e′ between the successful group and the failed group (all P<0.05). Multivariate regression analysis suggested that mechanical ventilation time and E/e′ were independent factors affecting the outcome of patients with respiratory failure ( OR=0.603, 0.282, all P<0.05). The area under ROC curve of E/e′ predicting mechanical ventilation withdrawal/ weaning failure was 0.844(95% CI: 0.729-0.959), which was superior to the RSBI and other cardiac ultrasound indexes. Conclusions:Echocardiography has predictive value for the outcome of mechanical ventilation of respiratory failure, and E/e′, which reflects the diastolic function of the heart, is the most effective predictor, but it is not suitable for single index prediction.
