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The following is a summary of “Hemodynamic monitoring during weaning from mechanical ventilation in critically ill pediatric patients: a prospective observational study,” published in the October 2024 issue of Pediatrics by Abdelgawad et al.
Cardiovascular dysfunction (CVD) significantly contributes to weaning failure in children mechanically ventilated (MV), necessitating an understanding of the cardiopulmonary changes during this process.
Researchers conducted a prospective study assessing the impact of weaning trials on central hemodynamics in children who are critically ill.
They evaluated hemodynamic parameters during weaning in patients MV (aged 2 to 30 months) using echocardiography and noninvasive cardiometry during pressure support (PS) ventilation and at the end of the spontaneous breathing trial (SBT).
The results showed that in 50 patients, 12 (25%) failed their first extubation trial, exhibiting significantly lower cardiac index (CI) and tricuspid annular plane systolic excursion (TAPSE) (P values = 0.001 and 0.001, respectively). Echocardiography revealed significant increases in CI, TAPSE, and the E/A ratio, while right ventricular systolic pressure (RVSP) significantly decreased. Noninvasive cardiometry showed substantial increases in the index of contractility (ICON) and CI at the end of SBT (P-value = 0.023 and < 0.001, respectively).
They concluded that children MV experienced hemodynamic changes affecting success, with echocardiography and noninvasive cardiometry helping detect potential heart dysfunction.
Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-024-05110-5
