Lung ultrasound score before and after extubation for predicting weaning outcome

Abstract

Background: Lung ultrasound (LUS) is an emerging, essential, safe and easily repeatable bed­side tool being used for the management of critically ill patients in ICUs. Weaning off the ventilator and decide to extubate require right decision and appropriate timing to avoid ex­tubation failure. The study aimed to perform LUS in planned extubation patients who passed SBT, for the assessment of lungs, before and after extubation.

Methods: A single-centre, observational study at medical ICU of a tertiary level hospital in Nepal was conducted on invasive mechanically ventilated patients. LUS was performed be­fore extubation on those who were planned to extubate and repeat scan done after 24 hours of extubation. LUS scores were calculated at both times. p-value 0.05 was considered statisti­cally significant.

Results: Twenty-eight patients were included after passing spontaneous breathing trial (SBT), one patient had extubation failure. Mean LUS score before and after extubation came to be 16.15 ± 7.00 and 13.15 ± 4.59 respectively with high degree of correlation (Pearson’s r = 0.896, P <0.001). The mean difference in LUS scores before and after extubation was signifi­cant (Mean difference: 3.00 ± 3.54, t = 4.402, p < 0.001).

Conclusions: Lung ultrasound is very useful additive tool in predicting extubation failure eas­ily and timely. Its use after extubation also helps in early prediction of post-extubation failure by assessing aeration changes and other lung pathology.