Role of Thoracic Fluid Content and Echocardiography in Weaning From Mechanical Ventilation

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Ahmed Abdel Moneim Ibrahim; Samia Mohamed Masoud; Khaled Mohamed Elsayed; Eslam Sobhy Elmaghawry


Weaning; Mechanical Ventilation; Thoracic Fluid; Echocardiography


Weaning from mechanical ventilation is a challenging step during recovery from critical illness. Thoracic fluid content (TFC) represents the fluid component in the thorax; thus, TFC was considered to provide an estimation of the extravascular lung water in absence of significant pleural or pericardial effusion. Various measures had been previously reported for evaluation of volume status such as fluid balance and echocardiography before the SBT aiming to identify patients who would benefit from diuretic therapy to achieve successful weaning from mechanical ventilation. Nowadays, there is an increasing interest in cardiac factors, such as lung congestion and hypervolemia, as contributing elements in weaning failure  and that needs expert physician. Although fluid balance and other previous measures could give us a good idea about weaning of patients from mechanical ventilation, thoracic fluid content measurement may also be beneficial and more accurate in this aspect. The electrical cardiometry-derived thoracic fluid content is measured through the impedance cardiography technology; TFC is assessed through the changes in the impedance of thoracic tissue to the electric current.  Trans-thoracic echocardiography is a non-invasive tool that delivers bedside cardiac function evaluation. Echocardiography is now widely used to evaluate cardiac function during the ventilator weaning process. The aim of the present study was to review the role of thoracic fluid content and echocardiography in weaning from mechanical ventilation.

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