How we use ultrasound in the management of weaning from mechanical ventilation
Abstract
Difficult weaning from invasive mechanical ventilation is associated with adverse clinical outcome and increased use of limited health care resources. Difficult weaning, characterized by failure of multiple spontaneous breathing trails (SBTs), can result from several causes, including impaired function of lung, heart, and respiratory pump [1]. In this editorial, we discuss how ultrasound may facilitate weaning from mechanical ventilation.
Critical care ultrasound (CCUS), in the hands of proper trained staff, is a valuable diagnostic tool across all stages of mechanical ventilation, including the weaning phase. During mechanical ventilation, CCUS allows for assessment of readiness for weaning. In case of weaning failure, it can identify the causes of weaning failure, and assess cardiorespiratory function and treatment response.
The ABCDE-ultrasound approach allows clinicians to review the pathophysiology of weaning failure effectively [2]. It allows for assessment of readiness for weaning and to diagnose and monitor the cause of weaning failure. The detailed use of CCUS in daily practice, following the ABCDE approach, is discussed in subsequent sections.