الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The current work was a prospective study which aimed to evaluate the role of lung ultrasound in detecting weaning induced pulmonary edema. Also, the study aimed to assess threshold of B lines that could be used for diagnosis of weaning induced pulmonary edema. It was done in the critical care unit of internal medicine department in Assiut University hospital between January 2021 and January 2022The study included patients on invasive mechanical ventilation who were suitable for SBT. It included 2 groups; the first group was patients with WIPE and the second group was patient without WIPO. Lung ultrasound was done using curvilinear probe according to the BLUE protocol before SBT. The number of B-lines was counted in a rib short-axis scan between two ribs at the four standardized BLUE points. SBT was performed on a “T-piece” connected to an oxygen source or CPAP or PS mode. The maximum duration for an SBT was set at 1 h, except in patients with a neurologic deficit where it could be prolonged. Lung ultrasound was done after SBT to determine the B-line increase that allows the diagnosis of WIPO with the best accuracy Among the 52 SBT, 25 trails were failed. 12 WIPO occurred, i.e. the prevalence of WIPO was 23% of all SBT and 48% of failing SBT.All cases of WIPO led to SBT failure. 29 patients without WIPE (72.5%) had simple weaning. In 13 patients without WIPE, the SBT failed due to respiratory exhaustion with hypoxemia in ten cases and consequences of neurological disorder (ICU-acquired weakness, myasthenia) in three other cases.ROC curve was analyzed to detect optimal cut-off values of delta B-lines for diagnosis of WIPO. The best accuracy for diagnosing of WIPO was reached when the Delta-B-lines were ≥ 5. In these cases, a Delta-B-lines ≥ 5 allowed the diagnosis of WIPO with a sensitivity of 83.3%, a specificity of 82.5%, a positive predictive value of 58.8% and a negative predictive value of 94.3%. When the analysis by ROC was performed by considering the success or failure of weaning, a cutoff value for the increase in B lines after SBT was ≥4 with a p value of 0.003, AUC = 0.741, Sensitivity = 68%% and Specificity = 85.