Antonio Ana Carolina Peçanha, Teixeira Cassiano, Castro Priscylla Souza, Savi Augusto, Maccari Juçara Gasparetto, Oliveira Roselaine Pinheiro, Knorst Marli Maria
Centro de Terapia Intensiva Adulto, Hospital Moinhos de Vento - Porto Alegre (RS), Brasil.
Centro de Terapia Intensiva Adulto, Hospital Mãe de Deus - Porto Alegre (RS), Brasil.
Rev Bras Ter Intensiva. 2017 Jul-Sep;29(3):279-286. doi: 10.5935/0103-507X.20170038. Epub 2017 Aug 21.
We aimed to investigate a potential association between B-lines and weaning failure.
Fifty-seven subjects eligible for ventilation liberation were enrolled. Patients with tracheostomy were excluded. Lung ultrasound assessments of six thoracic zones were performed immediately before and at the exnd of the spontaneous breathing trial. B-predominance was defined as any profile with anterior bilateral B-pattern. Patients were followed up to 48 hours after extubation.
Thirty-eight individuals were successfully extubated; 11 failed the spontaneous breathing trial and 8 needed reintubation within 48 hours of extubation. At the beginning of the T-piece trial, B-pattern or consolidation was already found at the lower and posterior lung regions in more than half of the individuals and remained non-aerated at the end of the trial. A trend toward loss of lung aeration during spontaneous breathing trials was observed only in the spontaneous breathing trial-failure group (p = 0.07), and there was higher B-predominance at the end of the trial (p = 0.01).
A loss of lung aeration during the spontaneous breathing trial in non-dependent lung zones was demonstrated in subjects who failed to wean.
我们旨在研究B线与撤机失败之间的潜在关联。
纳入57名符合通气解放条件的受试者。排除行气管切开术的患者。在自主呼吸试验开始前及结束时，对六个胸部区域进行肺部超声评估。B线优势定义为双侧前胸部出现任何B线模式。对患者拔管后48小时进行随访。
38人成功拔管；11人自主呼吸试验失败，8人在拔管后48小时内需要重新插管。在T管试验开始时，超过一半的个体在肺下部和后部区域已发现B线模式或实变，且在试验结束时仍无气体充盈。仅在自主呼吸试验失败组中观察到自主呼吸试验期间肺通气丧失的趋势（p = 0.07），且试验结束时B线优势更高（p = 0.01）。
在撤机失败的受试者中，非依赖肺区在自主呼吸试验期间出现肺通气丧失。
