• Clinics · Jan 2011

    Randomized Controlled Trial

    Echocardiographic evaluation during weaning from mechanical ventilation.

    • Luciele Medianeira Schifelbain, Silvia Regina Rios Vieira, Janete Salles Brauner, Deise Mota Pacheco, and Alexandre Antonio Naujorks.
    • Intensive Care Unit, Hospital de Caridade Dr. Astrogildo de Azevedo, Santa Maria, RS, Brazil. luciele@terra.com.br
    • Clinics (Sao Paulo). 2011 Jan 1;66(1):107-11.

    IntroductionEchocardiographic, electrocardiographic and other cardiorespiratory variables can change during weaning from mechanical ventilation.ObjectivesTo analyze changes in cardiac function, using Doppler echocardiogram, in critical patients during weaning from mechanical ventilation, using two different weaning methods: pressure support ventilation and T-tube; and comparing patient subgroups: success vs. failure in weaning.MethodsRandomized crossover clinical trial including patients under mechanical ventilation for more than 48 h and considered ready for weaning. Cardiorespiratory variables, oxygenation, electrocardiogram and Doppler echocardiogram findings were analyzed at baseline and after 30 min in pressure support ventilation and T-tube. Pressure support ventilation vs. T-tube and weaning success vs. failure were compared using ANOVA and Student's t-test. The level of significance was p<0.05.ResultsTwenty-four adult patients were evaluated. Seven patients failed at the first weaning attempt. No echocardiographic or electrocardiographic differences were observed between pressure support ventilation and T-tube. Weaning failure patients presented increases in left atrium, intraventricular septum thickness, posterior wall thickness and diameter of left ventricle and shorter isovolumetric relaxation time. Successfully weaned patients had higher levels of oxygenation.ConclusionNo differences were observed between Doppler echocardiographic variables and electrocardiographic and other cardiorespiratory variables during pressure support ventilation and T-tube. However cardiac structures were smaller, isovolumetric relaxation time was larger, and oxygenation level was greater in successfully weaned patients.

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