RESEARCH ARTICLE
Comparative Study between the use of Ultrasonic Criteria of Weaning versus the Conventional Criteria of Weaning in Post-traumatic Acute Respiratory Distress Syndrome Patients who were Ventilated for a long Time
Mohamed Gaber Ibrahim Mostafa Allam1, 2, *
Article Information
Identifiers and Pagination:
Year: 2023Volume: 17
E-location ID: e258964582309060
Publisher ID: e258964582309060
DOI: 10.2174/18743218-v17-e230913-2023-12
Article History:
Received Date: 26/03/2023Revision Received Date: 17/07/2023
Acceptance Date: 02/08/2023
Electronic publication date: 12/10/2023
Collection year: 2023
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Introduction:
Failure to wean and re-ventilation is a major problem in the intensive care unit (ICU). Thirty percent of ventilated patients experience weaning failure and are re-ventilated, especially patients who are ventilated for long durations. Ultrasound provides reliable data on lung parenchyma inflammation resolution and diaphragmatic contraction power, thereby assisting in deciding if the patient should be weaned and consequently reducing the percentage of weaning failure.
Aim of the Work:
To compare the ultrasonic criteria for weaning with the conventional criteria of weaning in patients with post-traumatic acute respiratory distress syndrome (ARDS) who were ventilated for a long time and assess their effect on the ICU stay duration.
Materials and Methods:
This was a prospective, double-blind study performed on 200 participants who were weaned from the ventilator after being ventilated for > 1 week due to respiratory failure. Respiratory failure in the patients was either due to severe lung contusion or post-traumatic ARDS. The patients were randomly and equally allocated in two groups of 100 patients each. Groups A and B comprised patients who were weaned from the ventilator using the conventional and ultrasound weaning criteria, respectively. All patients weaned from both groups were followed up for 6 days for signs of weaning failure and post-extubation respiratory failure. The number of patients who were re-ventilated and discharged from the ICU was recorded and compared in both groups.
Results:
Group A had a significantly higher number of patients who experienced deterioration in consciousness, tachypnea, desaturation, tachycardia, and hypertension in addition to showing chest X-ray infiltration and being re-ventilated than group B. Moreover, group A patients had a significantly longer ICU duration than group B patients.
Conclusion:
The use of the ultrasonic criteria for weaning reduces re-intubation, re-ventilation, and post-extubation respiratory failure. Additionally, its use also decreases the ICU stay in patients with post-traumatic ARDS who were ventilated for a long time.
