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

• DOI: 10.1186/s13613-021-00886-6
• Publication Date: 2021-06-28T13:03:17Z
• Authors: Martin Dres; Emmanuel Rozenberg; Elise Morawiec; Julien Mayaux; Julie Delemazure; Thomas Similowski; Alexandre Demoule
• Keywords: Diaphragm (acoustics); Spontaneous breathing trial

Abstract Background Diaphragm 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 is not particularly associated with oedema. Methods It a single-centre study conducted in patients who had failed first spontaneous breathing trial underwent second trial. The function evaluated by measuring the tracheal pressure generated response to bilateral magnetic phrenic nerves stimulations. Weaning-induced diagnosed case of failure if exhibited signs plasma concentration or echocardiographic diagnosis artery occlusion elevation. Results Fifty-three were included 31/53 (58%) trial, including 24/31 (77%) present 33/53 (62%) patients. 26/31 (84%) occurred 20/33 (61%) 4/20 (20%) without ( p = 0.005). Conclusion three times more frequent dysfunction. Even dysfunction, physicians might be encouraged investigate presence failure.