Mitral Annular Plane Systolic Excursion (MAPSE) as a Predictor of Weaning Failure in Mechanically Ventilated Patients

Abstract

Weaning failure is multifactorial in nature; it can result from diaphragmatic dysfunction, excess mechanical load, weaning-induced cardiovascular dysfunction, or a reduced ability to clear secretions. To investigate mitral annular plane systolic excursion (MAPSE) by using M-mode echocardiography as a predictor of weaning failure and its relation to length of intensive care unit stay, and to hospital mortality, and correlation of MAPSE with APACHE II and SOFA scores as predictors of outcome. This was a prospective observational cohort study conducted on 50 patients admitted to Critical Care Medicine Department, Cairo University Hospitals (Kasr Al-Aini Hospitals), with a diagnosis of acute respiratory failure who required mechanical ventilation, from January 2019 to December 2020. There was significant relation between weaning from mechanical ventilation and APACHE II score, we found highly significant difference with SOFA score. ROC curve for detection of weaning using MAPSE showed Area Under the Curve of 0.918 with highly statistically significant relation with cut off value is 13.9 with Sensitivity 83.3% and Specificity 92.3%; and thus, MAPSE could be a good indicator for successful weaning. We concluded that; Low Mitral annular plane systolic excursion (MAPSE) could be a good predictor of weaning failure and mortality, The higher MAPSE values are correlated with lower ICU stay duration. We found that RSBI and SOFA score are predictors for successful weaning, also SOFA and APACHE II scores are indicators of mortality.