Table 1.
Patient characteristics and echocardiographic variables just before the weaning process, according to weaning category (n = 67)
| All patients (n = 67) |
Weaning | p | ||
|---|---|---|---|---|
| Short (n = 49) |
Prolonged (n = 18) |
|||
| Patient characteristics | ||||
| Age, year | 64 (47–76) | 61 (49–75) | 69 (44–81) | 0.50 |
| Male sex | 44 (66) | 31 (63) | 13 (72) | 0.49 |
| SAPS II at ICU admission | 46 (34–53) | 44 (34–58) | 46 (34–50) | 0.50 |
| Comorbidities | ||||
| Hypertension | 33 (49) | 23 (47) | 10 (56) | 0.52 |
| Diabetes | 17 (26) | 9 (19) | 8 (44) | 0.05 |
| Chronic obstructive pulmonary disease | 17 (25) | 13 (27) | 4 (22) | > 0.99 |
| History of ischemic heart disease | 13 (19) | 11 (22) | 2 (11) | 0.48 |
| Atrial fibrillation | 22 (33) | 13 (27) | 9 (50) | 0.07 |
| Reason for intubation | 0.67 | |||
| Coma | 13 (19) | 9 (18) | 4 (22) | |
| Septic shock | 8 (12) | 5 (10) | 3 (17) | |
| Cardiogenic pulmonary edema | 17 (25) | 14 (29) | 3 (17) | |
| Pneumonia | 18 (27) | 12 (25) | 6 (33) | |
| Cardiac arrest | 4 (6) | 4 (8) | 0 (0) | |
| Surgery | 7 (10) | 5 (10) | 2 (11) | |
| Events between ICU admission and inclusion | ||||
| Septic shock | 33 (49) | 25 (51) | 8 (44) | 0.63 |
| Ventilator-associated pneumonia | 15 (22) | 9 (18) | 6 (33) | 0.21 |
| Acute respiratory distress syndrome | 26 (39) | 18 (37) | 8 (44) | 0.56 |
| Use of neuromuscular blockers | 11 (16) | 9 (18) | 2 (11) | 0.71 |
| Cumulative fluid balance before inclusion, mL | 4322 (949–7898) | 4322 (175–7253) | 4228 (1757–17,957) | 0.27 |
| Duration of invasive MV before inclusion, days | 3 (2–6) | 3 (2–6) | 5 (3–13) | 0.08 |
| Clinical and biological data at inclusion | ||||
| SOFA score | 4 (3–6) | 4 (3–6) | 5 (4–6) | 0.25 |
| Systolic arterial pressure, mmHg | 129 (122–144) | 132 (113–146) | 127 (108–136) | 0.44 |
| Heart rate, beats/min | 93 (82–105) | 93 (83–106) | 91 (79–104) | 0.60 |
| Respiratory rate, beats/min | 25 (19–30) | 23 (18–29) | 29 (27–33) | 0.06 |
| RPP, beats/min·mmHg | 12,500 (11,288–15,346) | 12,576 (10,744–15,520) | 12,423 (12,245–13,035) | > 0.99 |
| Arterial blood gases | ||||
| pH, units | 7.44 (7.40–7.47) | 7.44 (7.40–7.47) | 7.44 (7.41–7.47) | 0.77 |
| PaO2/FiO2 ratio, mmHg | 210 (182–270) | 222 (188–277) | 186 (153–226) | < 0.01 |
| PaCO2, mmHg | 41 (35–46) | 40 (35–46) | 42 (37–49) | 0.42 |
| BNP, pg/ml | 331 (114–602) | 302 (108–588) | 415 (114–842) | 0.51 |
| Protidemia, g/L | 58 (51–66) | 58 (54–66) | 54 (49–66) | 0.39 |
| Creatinine, micromol/L | 79 (57–101) | 81 (59–98) | 73 (55–107) | 0.96 |
| Randomization in the interventional group | 34 (51) | 25 (51) | 9 (50) | 0.94 |
| Echocardiographic variables | ||||
| LVEF, % | 55 (40–60) | 50 (37–60) | 60 (50–62) | 0.26 |
| Cardiac index, L/min/m2 | 3.0 (2.2–3.6) | 3.1 (2.3–3.6) | 2.7 (2.1–3.7) | 0.52 |
| Systolic dysfunction | ||||
| LVEF < 50% | 25 (37) | 21 (43) | 4 (22) | 0.12 |
| Diastolic dysfunction a | ||||
| LVEF ≥ 50% and BNP > 35 pg/mL and (E/e′ ratio ≥ 13 or e′ < 9) | 11 (17) | 4 (8) | 7 (39) | 0.01 |
| Heart valve diseaseb | 23 (34) | 14 (29) | 9 (50) | 0.10 |
| RV/LV area ratio | 0.6 (0.5–0.7) | 0.6 (0.4–0.7) | 0.6 (0.5–0.7) | 0.67 |
| Tricuspid annular plane systolic excursion, cm | 1.9 (1.5–2.6) | 2.1 (1.7–2.7) | 1.5 (1.3–1.9) | 0.03 |
| Systolic pulmonary artery pressure, mmHg | 38 (25–51) | 37 (25–49) | 46 (25–66) | 0.16 |
SAPS Simplified Acute Physiologic Score, ICU intensive care unit, MV mechanical ventilation, SOFA sequential organ failure assessment, RPP product of heart rate and systolic arterial pressure, FiO2 fraction of inspired oxygen, BNP B-type natriuretic peptide, LVEF left ventricle ejection fraction, E early diastolic velocity measured using Doppler transmitral flow, A late diastolic velocity measured using Doppler transmitral flow, e′ early peak diastolic velocity of mitral annulus, a′ late peak diastolic velocity of mitral annulus, RV right ventricular end-diastolic area, LV left ventricular end-diastolic area
aDiastolic function could not be assessed in one patient for e′ and in two patients for E/e′ ratio
bHeart valve disease is defined as a severe aortic or mitral regurgitation (grade III/IV). Data are presented as n (%) or median (1st quartile–3rd quartile)