الفهرس 
Weaning from mechanical ventilation and itsOnly 14 pages are availabe for public view
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Abstract
Background: Cardiovascular dysfunction could be a major
underlying mechanism of weaning failure. BNP; a marker for
cardiovascular dysfunction, may predict the outcome of weaning from
MV.
Objective: To evaluate the role of BNP levels measured during
start of MV& SBT as a predictive value for weaning outcome.
Method: Thirty patients difficult weaning from MV who
underwent an SBT. .Echocardiography was done at start of MV and
sampling of N-terminal pro BNP at start of MV and at SBT to determine
the predictive value of BNP.
Results: Patients throughout the SBT trial showed increase of
RSBI (108.1±9.8 vs.40.6±6.9 breath/min/l p<0.05) & P/F І was higher
than P/FІІ (206.3±38 vs. 111.4±17.5, p≤ 0.05). and ECHO data showed
all patients had diastolic dysfunction and grade ІІ represented 70% and
grade І represented30%, there was increase in N -terminal pro BNP at
SBT (15275±6667.7vs 1599.7±1448.7 ng/L p <0.05). By using ROC
analysis we found that at a cutoff point of 1765 ng/L of N-terminal pro
BNP at start of MV we can predict weaning failure and mortality with
sensitivity 78.3% & specificity 57.1% And at a cutoff point18500 ng/L of
N-terminal pro BNP at SBT we can predict weaning failure and mortality
with sensitivity 87% & specificity 57.1%.The mean of N-terminal pro
BNP in non-survivor at start of MV was 2764.3 ng/L with p-value<0.05
and 20178.6 ng/L with p- value<0.05 at SBT and we found the mean
among survivor at start of MV was 1245.2 ng/L with p-value <0.05 and
the mean was13782.6ng/L with p-value <0.05 at SBT.
Conclusions: N-terminal pro BNP and left ventricular diastolic
dysfunction at start of MV can be used to predict weaning failure as well
as mortality in MV patients due to cardiac cause.