Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Critical Care Medicine

Aim of work: To asses whether lung derecruitment during spontaneous breathing trial and postextubation assessed by lung ultrasound is predictive of postextubation distress. Results: Mean age was 56.66 ±6.36, 56% were males. Twelve patients failed the spontaneous breathing trial, 38 were extubated. 24 were definitively weaned (postextubation success group), and 14 suffered from postextubation distress. Loss of lung aeration at end of spontaneous breathing trial was marked in patients with postextubation distress, and increased from (11.57±2.24) to (14.93±2.23). ROC curve has an excellent predictive value for postextubation distress with area under the curve (AUC) 0.972 & cutoff value LUS {u2265}11 at the end of spontaneous breathing trial, with asensitivity of 100% & a specificity of 88%. ROC curve for difference in LUS between basal &end of trial showed an excellent predictive value for postextubation distress with sensitivity 100% & specificity 83% at cutoff value {u2265} 3 ( area under the curve = 0.91 ). Conclusion: Lung ultrasound determination of aeration changes during a successful spontaneous breathing trial accurately predict postextubation distress

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