Thoracic Fluid Content: A Novel Parameter for Prediction of Successful Weaning of Neonates on Mechanical Ventilation. A Prospective Observational Study

Document Type : Research article


Department of pediatrics, faculty of medicine,Ain shams university, Cairo, Egypt


Background: In an intensive care unit, weaning patients from artificial breathing remains a crucial decision.
Aim of the work: to assess thoracic fluid content as a measure for prediction of successful weaning of neonates on mechanical ventilation
Methods: Forty neonates who met the inclusion criteria for this prospective observational study were divided into 3 groups; first group: 25 patients were successfully extubated from the first time , second group: 15 patients failed extubation and were reintubated and third group:15 were successfully extubated after initial failure(retested again).Thoracic fluid content was assessed using electrical cardiometry for each participant before and after extubation from mechanical ventilation and Echocardiography was also performed before and after extubation
Results: Most baseline variables were similar among the studied groups ; however, Compared to the successful weaning groups, the failed weaning group's TFC was significantly higher. The optimal cut off point was determined by analyzing the region beneath the ROC, Regarding the use of TFC prior to extubation to identify failure cases, the AUC was 0.997 at a cut-off point of >44, with 100% sensitivity and 96.0% specificity, a PPV of 93.7, and an NPV of 100.0. AUC was 100, PPV was 100, NPV was 100.0, and it had 100% sensitivity and 100% specificity at the cut-off point of >41
Conclusion: The thoracic fluid content prior to extubation is a good predictive marker of successful weaning. Patients with Thoracic fluid content >44 were expected to fail extubation and patients with TFC< 41 were expected to be extubated successfully.


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