Background: Mechanical ventilation weaning is a fundamental aspect of managing
patients diagnosed with respiratory failure. Failure to wean successfully can lead to
prolonged ventilation, increased morbidity, extended hospital stays, and higher
mortality. Identifying reliable predictors of weaning success is therefore essential.
Diaphragmatic ultrasound allows for direct assessment of diaphragmatic function and
has been associated with improved weaning outcomes. Thoracic fluid content (TFC),
a hemodynamic parameter measured by electrical cardiometry, reflects thoracic fluid
status and inversely correlates with thoracic impedance. Elevated TFC has been
linked to lung congestion and may serve as an early predictor of weaning failure.
Objective: This review article aims to evaluate the predictive value of TFC measured
by electrical cardiometry in combination with diaphragmatic excursion assessed by
ultrasound for forecasting weaning success in patients with signs of pulmonary
congestion. Methods: A literature search was conducted through PubMed, Scopus,
and Google Scholar using keywords including “Thoracic fluid content”, “Electrical
cardiometry”, “Diaphragmatic excursion”, “Ultrasound”, and “Weaning from MV”.
Articles published in English from 2000 to 2024 that investigated non-invasive
predictors of weaning outcomes were reviewed. Conclusion: TFC provides a non-
invasive estimate of extravascular lung water, making it a potentially valuable tool in
assessing readiness for ventilator weaning. When combined with diaphragmatic
ultrasound, these measures may offer a more accurate and individualized approach to
predict weaning success, particularly in patients with lung congestion. |
