Cardiac function during weaning failure: the role of diastolic dysfunction

Background Cardiac dysfunction is a common cause of weaning failure. Weaning shares some similarities with a cardiac stress test and may challenge active phases of the cardiac cycle-like ventricular contractility and relaxation. This study aimed at assessing systolic and diastolic function during th...

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Vydáno v:Annals of intensive care Ročník 8; číslo 1; s. 2 - 11
Hlavní autoři: Roche-Campo, Ferran, Bedet, Alexandre, Vivier, Emmanuel, Brochard, Laurent, Mekontso Dessap, Armand
Médium: Journal Article
Jazyk:angličtina
Vydáno: Cham Springer International Publishing 09.01.2018
Springer Nature B.V
SpringerOpen
Témata:
Anesthesiology
Critical Care Medicine
Diastolic function
Diastolic reserve
Electrocardiography
Emergency Medicine
Heart rate
Intensive
Intensive care
Medical procedures
Medicine
Medicine & Public Health
Patient assessment
Relaxation
Ventilators
Weaning
Diastolic function
Diastolic reserve
Relaxation
Weaning
ISSN:2110-5820, 2110-5820
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Shrnutí:Background Cardiac dysfunction is a common cause of weaning failure. Weaning shares some similarities with a cardiac stress test and may challenge active phases of the cardiac cycle-like ventricular contractility and relaxation. This study aimed at assessing systolic and diastolic function during the weaning process and scrutinizing their dynamics during weaning trials. Methods Echocardiography was performed during baseline ventilator settings to assess cardiac function at the initiation of the weaning process and at the start and the end of consecutive weaning trials (performed at day-1, day-2, and before extubation if applicable) to explore the evolution of left ventricle contractility and relaxation in a subset of patients. Results Among 67 patients included, weaning was prolonged (≥ 7 days) in 18 (27%) patients and short (< 7 days) in 49 (73%). Prevalence of systolic dysfunction and isolated diastolic dysfunction before the initiation of weaning process were 37 and 17%, respectively. Isolated diastolic dysfunction was more frequent in patients with prolonged weaning as compared to their counterparts. Thirty-one patients were explored by echocardiography during consecutive weaning trials. An increase in filling pressures with an alteration of ventricular relaxation (as assessed by a decrease in tissue Doppler early mitral diastolic wave velocity) was found during failed weaning trials. Conclusions Isolated diastolic dysfunction was associated with a prolongation of weaning. Increased filling pressures with left ventricle relaxation impairment may be a key mechanism of weaning trial failure.
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ISSN:2110-5820
2110-5820
DOI:10.1186/s13613-017-0348-4