Thoracic fluid content: a novel parameter for predicting fai
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Weaning of patients from the mechanical ventilation remains one of the critical decisions in intensive care unit. Screening for eligibility is the first step in weaning process, followed by the spontaneous breathing trial (SBT). Various indices should be checked carefully before starting SBT to ensure adequate oxygenation, ventilation, and airway reflexes.Thoracic fluid content (TFC) represents the whole (extravascular, intravascular, and intrapleural) fluid component in the thorax.

In this study, researchers aimed to evaluate the accuracy of TFC, as an estimate of lung congestion, in predicting weaning outcome in critically ill patients.

An observational cohort study included 64 critically ill surgical patients who were eligible for extubation. Before initiating the spontaneous breathing trial, the TFC was measured using the electrical cardiometry technology. Patients were followed up after extubation and divided into successful weaning group and failed weaning group. Both groups were compared according to respiratory and cardiovascular parameters.

The number of successfully weaned patients was 41/64 (64%). Twenty (31%) patients had impaired cardiac contractility, and of them, 13/20 (64%) patients were successfully extubated. Both groups, successful weaning group and failed weaning group, were comparable in most of baseline characteristics; however, the TFC was significantly higher in the failed weaning group compared to the successful weaning group.

Thoracic fluid content showed moderate ability for predicting weaning outcome in surgical critically ill patients. However, in the subgroup of patients with ejection fraction less than 40%, TFC above 50 kΩ−1 has an excellent ability to predict weaning failure.