Diaphragm dysfunction, lung aeration loss and weaning-induced pulmonary oedema in difficult-to-wean patients View Full Text


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Article Info

DATE

2021-06-28

AUTHORS

Martin Dres, Emmanuel Rozenberg, Elise Morawiec, Julien Mayaux, Julie Delemazure, Thomas Similowski, Alexandre Demoule

ABSTRACT

BackgroundDiaphragm dysfunction and weaning-induced pulmonary oedema are commonly involved during weaning failure, but their physiological interactions have been poorly reported. Our hypothesis was that diaphragm dysfunction is not particularly associated with weaning-induced pulmonary oedema.MethodsIt was a single-centre and physiological study conducted in patients who had failed a first spontaneous breathing trial and who underwent a second trial. The diaphragm function was evaluated by measuring the tracheal pressure generated in response to a bilateral magnetic phrenic nerves stimulations. Weaning-induced pulmonary oedema was diagnosed in case of failure of the spontaneous breathing trial if patients exhibited signs of plasma concentration or echocardiographic diagnosis of pulmonary artery occlusion pressure elevation.ResultsFifty-three patients were included and 31/53 (58%) failed the spontaneous breathing trial, including 24/31 (77%) patients with weaning-induced pulmonary oedema. Diaphragm dysfunction was present in 33/53 (62%) patients. Diaphragm dysfunction or weaning-induced pulmonary oedema were present in 26/31 (84%) of the patients who failed the spontaneous breathing trial. Weaning-induced pulmonary oedema occurred in 20/33 (61%) patients with a diaphragm dysfunction and in 4/20 (20%) patients without (p = 0.005).ConclusionWeaning-induced pulmonary oedema was three times more frequent in case of diaphragm dysfunction. Even in case of diaphragm dysfunction, physicians might be encouraged to investigate the presence of weaning-induced pulmonary oedema during weaning failure. More... »

PAGES

99

References to SciGraph publications

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  • 2019-03-12. Lung ultrasound allows the diagnosis of weaning-induced pulmonary oedema in INTENSIVE CARE MEDICINE
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  • 2008-02-23. Increase in plasma protein concentration for diagnosing weaning-induced pulmonary oedema in INTENSIVE CARE MEDICINE
  • 2019-01-09. Weaning failure of cardiovascular origin: how to suspect, detect and treat—a review of the literature in ANNALS OF INTENSIVE CARE
  • 2014-05-27. Weaning-induced cardiac dysfunction: where are we today? in INTENSIVE CARE MEDICINE
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    http://scigraph.springernature.com/pub.10.1186/s13613-021-00886-6

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    http://dx.doi.org/10.1186/s13613-021-00886-6

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/34181105


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    35 diaphragm function
    36 dysfunction
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    39 elevation
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    42 function
    43 hypothesis
    44 interaction
    45 loss
    46 lung aeration loss
    47 magnetic phrenic nerve stimulation
    48 nerve stimulation
    49 patients
    50 phrenic nerve stimulation
    51 physicians
    52 physiological interactions
    53 physiological studies
    54 plasma concentrations
    55 presence
    56 pressure
    57 pressure elevation
    58 pulmonary edema
    59 response
    60 second trial
    61 signs
    62 spontaneous breathing trial
    63 stimulation
    64 study
    65 time
    66 tracheal pressure
    67 trials
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    69 weaning-induced pulmonary edema
    70 weaning-induced pulmonary oedema
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