Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Hemodynamic changes during weaning: can we assess and predict cardiac-related weaning failure by transthoracic echocardiography? | Voga Critical Care 2010 14 174 http content 14 4 174 CRITICAL CARE COMMENTARY L__ Hemodynamic changes during weaning can we assess and predict cardiac-related weaning failure by transthoracic echocardiography Gorazd Voga See related research by Caille etal. http content 14 3 R120 Abstract Cardiac-related failure of weaning from mechanical ventilation is an important reason for prolonged mechanical ventilation intensive care unit treatment and increased morbidity and mortality. When transthoracic echocardiography TTE is routinely performed before a weaning trial patients at high risk of cardiac-related failure can be detected by low left ventricular LV ejection fraction diastolic dysfunction and elevated LV filling pressure. During the weaning trial a further increase of LV filling pressure and progression of diastolic failure can be observed by repeated TTE. Owing to certain limitations concerning patients and methodology TTE cannot be employed in every patient and invasive hemodynamic monitoring is still mandatory in selected patients with repetitive weaning failure. In the previous issue of Critical Care Caille and colleagues 1 evaluated the ability of transthoracic echocardiography TTE to predict cardiac-related weaning failure and to assess the hemodynamic changes before and 30 minutes after the start of a spontaneous breathing trial SBT . The authors measured maximal velocities of mitral E and A waves deceleration time of E wave DTE maximal velocity of E wave measured by tissue Doppler at lateral mitral annulus and left ventricular LV stroke volume. Weaning failed in 23 of 117 patients and failure was of cardiac origin in the majority 20 of 23 of them. In patients with weaning failure a significantly lower heart Correspondence Medical Intensive Care Unit General Hospital Celje Oblakova 5 3000 Celje Slovenia 2 BioMed Central 2010 BioMed Central Ltd rate and E E ratio and a higher left ventricular .
