Abstract
Objective: This prospective cohort study was designed to assess the rule of myocardial performance (Tei) index and NT-Pro BNP serum levels in prediction of weaning failure in mechanically ventilated COPD patients. Methods: Forty patients with respiratory failure due to acute exacerbation of COPD were enrolled to this study. All patients underwent a comprehensive echocardiographic examination including tissue doppler imaging within first 12 hours of admission. NT-pro BNP serum levels were measured on admission. Patients were followed up for outcome of weaning failure. Results: Right ventricular Tei index was higher in patients with failed weaning in comparison to successfully weaned patients (mean 0.66 versus 0.36, P < 0.001), also left ventricular Tei index was higher in patients who failed to be weaned (mean 0.45 versus 0.36, P = 0.007). There was no difference in serum NT-Pro BNP between successfully weaned patients and patients with weaning failure. Right ventricular Tei index showed higher accuracy in predicting weaning failure than the left ventricular Tei index (AUC 0.932 versus 0.754), while serum NT-Pro BNP showed no discrimination in predicting weaning failure (AUC 0.556). Conclusion: Tei index was superior to NT-ProBNP in prediction of weaning failure in COPD patients.
Highlights
In this study, we aimed to evaluate the relationship between the LV, RV the rule of myocardial performance (Tei) index and Pro BNP and compare between as predictors of difficult weaning
The study was conducted at a university hospital, a tertiary care hospital at critical care department, the study was approved by the local ethics committee and written informed consent was obtained from all patients
Tei index was calculated from recordings of five consecutive cardiac cycles with simultaneous electrocardiography using tissue Doppler at medial and lateral mitral and tricuspid annulus the mean were calculated
Summary
This Prospective cohort enrolled forty mechanically ventilated patients according to sample size calculation with AECOPD. The study was conducted at a university hospital, a tertiary care hospital at critical care department, the study was approved by the local ethics committee and written informed consent was obtained from all patients. Hemodynamic instability, patients compliant to noninvasive mechanical ventilation and or those technically difficult transthoracic echocardiographic techniques were excluded from the study. Hemodynamic instability was defined by the presence a systolic blood pressure < 90 or need of vasopressor therapy. Patients were followed up till discharge from ICU
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