Predictors of Success of Weaning from Mechanical Ventilation in Critically Ill Pediatric Patients

Abstract

Initiation of weaning from mechanical ventilation by progressive withdrawal from invasive ventilator support until removal of the endotracheal tube might represent approximately 42% of the duration of mechanical ventilation. SBT assesses the ability of the patient to breathe while receiving minimal or no ventilator support. Adequate performance of SBT does not necessarily result in successful extubation. The process of SBT start by assessing the underlying cause of respiratory failure has be removed or not. Multiple parameters subjective & objective had been successfully used to determine reversal of the disease and readiness for weaning. Bedside assessments tools are also crucial during weaning. Ultrasonography (USG) has been used in the routine assessments of seriously ill patients for diagnostic approach and follow-up. It is a convenient tool to evaluate cardiac function, diaphragm function, lung aeration. The present study is a prospective randomized cohort study conducted on 50 children who had been admitted to Pediatric Intensive Care Units (PICUs), Pediatric Hospital, Ain Shams University, in the period between March 2018 to March 2019. The aim of the study was to assess the ability to use lung, diaphragmatic ultrasound and transthoracic echocardiography (TTE) to identify different indices that could help in predicting the weaning outcome in ventilated pediatric patients. Also it studied the value of Rapid Shallow Breathing Index (RSBI) and Integrated Weaning Index (IWI) measured at initiation and termination of a SBT in predicting the weaning outcome.