• Hanan Mohamed Mohamed Mohamed Mostafa, Mohamed Amr Abd El-Fattah Mattar, Niveen Mahmoud Abd El-Malek Gouda, AlkhatipAhmed Abdelaal Ahmed Mahmoud MAAAMMDepartment of Anaesthesia, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt., and Mohamed Khaled Mohamed Hamza.
• Department of Anaesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt.
• J. Cardiothorac. Vasc. Anesth. 2022 Aug 1; 36 (8 Pt B): 2884-2890.

ObjectivesWeaning individuals from mechanical ventilation (MV) is a challenge to physicians. Respiratory failure is the main reason for weaning failure (WF), but heart failure plays a pivotal role as well. Transesophageal Doppler (TED) is a minimally invasive method of hemodynamic tracking with fewer problems. The study authors evaluated the role of TED in predicting WF.DesignAn observational study.SettingA university teaching hospital.ParticipantsWeaning individuals.InterventionsTED was applied before initiating the spontaneous breathing trial (SBT). Hemodynamic parameters, arterial blood gases, and TED (peak velocity [PV], cardiac output [COP]) were reported while cases were on MV before initiating the SBT, and at the successful completion of SBT. Succeeded (group S) and failed individuals (group F, who needed reintubation within 48 hours) were compared. The sensitivity, specificity, and area under the receiver operating curve were calculated. A subgroup of patients with cardiac comorbidities and impaired cardiac contractility was further analyzed.Measurements And Main ResultsThe authors included 39 critically ill patients for weaning from MV. The reintubation rate was 54.8%. In patients with cardiac morbidity, delta change (dC) in PV and COP as predictors of WF showed 100% sensitivity and specificity, with 18% and 14% cut-offs after initiating the SBT (dC between the beginning and end of the successful SBT), respectively. Central venous oxygen saturation revealed a significant difference between patients with cardiac morbidity and noncardiac patients with lower sensitivity and specificity in the prediction of WF.ConclusionsTED could be a helpful method for the weaning of patients with cardiac morbidity from MV. The dC in PV and COP >18% and >14% were significant predictors of WF in these subjects, respectively.Copyright © 2022 Elsevier Inc. All rights reserved.

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