Thoracic fluid content measured by electrical cardiometry as a predictor of weaning outcomes from mechanical ventilator in adult patients after cardiac surgery: A prospective, observational study

Abstract

Background: Weaning of patients from mechanical ventilation is always a challenging decision in the intensive care unit. This study was designed to assess the ability of thoracic fluid content (TFC) measured by electrical cardiometry to predict weaning outcomes from mechanical ventilators in adult patients after cardiac surgery. Patients and Methods: This observational cohort study included 60 patients who were classified as American Society of Anesthesiologists (ASA) physical status II or III, New York Heart Associations (NYHA) class II or III, aged between 18 and 65 years old, who underwent elective cardiac surgery with cardiopulmonary bypass, and were eligible for extubation after surgery. Electrical cardiometry was used for measuring TFC before, at the beginning, and at 30 min of spontaneous breathing trial. Follow-up of the patients after extubation was done and patients were classified into the successful weaning group and failed weaning group. The receiver operating characteristic curve was analyzed to assess the ability of TFC to predict successful weaning. Results: Successful weaning occurred in 37 (66.1%) patients and failed weaning occurred in 19 (33.9%) patients. Both groups showed comparable results in many baseline characteristics; however, the TFC was significantly increased in the failed weaning group in comparison with the successful weaning group. The area under the ROC curve (AUC) exhibited excellent predictive ability of the TFC at 30 min of SBT in predicting successful weaning (AUC 0.97, cutoff value <45 kΩ−1). Conclusion: TFC measured by electrical cardiometry was a strong predictor of successful weaning from mechanical ventilator in adult patients post-cardiac surgery.

Keywords

• cardiac surgery
• electrical cardiometry
• thoracic fluid content
• weaning