The Use of Lung Ultrasound in the Diagnosis of Weaning‑Induced Pulmonary Oedema in Mechanically Ventilated Patients

Abstract

Failure of weaning from mechanical ventilation is independently associated with poor outcome in critically ill patients [1]. Identifying the cause of weaning failure helps to determine the appropriate treatment, which may prompt weaning. During weaning from mechanical ventilation, usually during a spontaneous breathing trial (SBT), heart–lung interactions impair the cardiac loading conditions, which may lead to pulmonary oedema which subsequently will lead to weaning failure. Detecting WIPO is potentially important and useful, because it can be easily treated. Measuring the pulmonary artery occlusion pressure during an SBT directly evidences the increase in hydrostatic pulmonary pressure [3]. However, less invasive alternative methods have been developed, like the assessment of blood volume contraction, increase in B-type natriuretic peptide (BNP), in the left ventricular filling pressure at echocardiography [9] or in extravascular lung water. For many years, the reference criterion for diagnosing WIPO was an SBT-induced increase in the pulmonary artery occlusion pressure, measured through a pulmonary artery