Articles Vol. 66 No. CĐ13- HNKH Gây mê Hồi sức 25/09/2025

49. PREDICTING THE WEANING VENTILATOR OUTCOME OF SURGICAL CRITICAL CARE PATIENTS USING CARDIAC, LUNG AND DIAPHRAGM ULTRASONOGRAPHY

Tran Viet Duc1,2,3,4, Nguyen Huu Tu1,2,3,5, Vu Hoang Phuong1,2,3,5
1 Hanoi Medical University
2 Hanoi Medical University Hospital
3 Trường Đại học Y Hà Nội
4 Bệnh viện Đại học Y Hà Nội
5 Bệnh viện Trường Đại học Y Hà Nội
Corresponding author: ductran.hmu@gmail.com
DOI: 10.52163/yhc.v66iCD13.3215
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Keywords
Weaning ventilator, spontaneous breathing trial, cardiac ultrasound, lung ultrasound, diaphragm ultrasound.
Abstract

Objective: This study aimed to evaluate the accuracy of lung, cardiac, and diaphragm ultrasound in predicting weaning failure in surgical intensive care patients.

Methods: Patients who had been mechanically ventilated via an endotracheal tube for more than 48 hours and were ready for their first spontaneous breathing trial were included. Spontaneous breathing trial was conducted for 1 hour using a pressure support mode of 7 cmH₂O. Ultrasound assessments were performed immediately before the spontaneous breathing trial.

Results: Among 69 patients, 22 patients (31.9%) experienced weaning failure. The failure group had significantly higher total lung ultrasound scores, anterior lung ultrasound scores, anterolateral lung ultrasound scores, and posterior lung ultrasound scores, while diaphragm excursion and diaphragm thickening fraction were significantly lower compared to the successful group. Multivariate regression analysis identified anterolateral lung ultrasound score > 9.5, diaphragm excursion < 1.3 cm, and diaphragm thickening fraction < 17.7% before spontaneous breathing trial as independent predictors of weaning failure.

Conclusion: Lung and diaphragm ultrasound provide good predictive value for weaning failure in surgical intensive care patients.

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