Echocardiographic diagnosis of pulmonary artery occlusion pressure elevation during weaning from mechanical ventilation*

• DOI: 10.1097/ccm.0b013e31819f13d0
• Publication Date: 2009-05-21T16:28:27Z
• Authors: Bouchra Lamia; Julien Maizel; Ana Ochagavia; Denis Chemla; David Osman; Christian Richard; Jean-Louis Teboul
• Keywords: Pulmonary wedge pressure

Weaning-induced pulmonary edema is a cause of weaning failure in high-risk patients. The diagnosis may require artery catheterization to demonstrate increased occlusion pressure (PAOP) during weaning. Transthoracic echocardiography can estimate left ventricular filling pressures using early (E) and late (A) peak diastolic velocities measured with Doppler transmitral flow, tissue imaging mitral annulus including (Ea) velocity. We tested the hypothesis that E/A E/Ea could be used detect weaning-induced PAOP elevation defined by > or =18 mm Hg spontaneous breathing trial (SBT).We included 39 patients who previously failed two consecutive SBTs. A third SBT was performed over maximum 1-hour period T-piece. PAOP, E/A, were before this SBT. Receiver operating characteristic curves constructed determine optimal sensitivity specificity values obtained at end for predicting elevation. occurred 17 value >0.95 predicted 88% 68%. >8.5 94% 73%. combination 82% 91%.At an SBT, transthoracic allowed accurate noninvasive detection