@article {Antoniorespcare.05817, author = {Ana Carolina P Antonio and Marli M Knorst and Cassiano Teixeira}, title = {Lung Ultrasound Prior to Spontaneous Breathing Trial Is Not Helpful in Weaning the Decision Making Process}, elocation-id = {respcare.05817}, year = {2018}, doi = {10.4187/respcare.05817}, publisher = {Respiratory Care}, abstract = {BACKGROUND: Lung ultrasound is increasingly becoming a diagnostic tool in the critical care setting. B-pattern on a lung ultrasound is an artifact composed of multiple B-lines and correlates with interstitial edema. A randomized controlled trial concluded that bedside thoracic ultrasound could predict postextubation distress through changes in lung aeration during a weaning procedure; however, it could not screen patients before performance of a spontaneous breathing trial (SBT).METHODS: We conducted a 2-year, prospective, multicenter, observational study in 2 adult medical-surgical ICUs in southern Brazil. All enrolled subjects met eligibility criteria for ventilation liberation. Patients with tracheostomy were excluded. Lung ultrasound was performed immediately before SBT. B-predominance was defined as any profile with anterior bilateral B-pattern. The primary outcome was SBT failure, defined as the inability to tolerate a T-piece trial of 30{\textendash}120 min, in which case subjects were not extubated.RESULTS: From 2011 to 2013, 250 subjects undergoing weaning procedures were evaluated. SBT failure occurred in 51 (20.4\%) subjects. Subjects with a successful SBT were extubated on the first attempt in 75.6\% of cases. B-predominance was a very weak predictor for SBT outcome, showing 47\% sensitivity, 64\% specificity, 25\% positive predictive value, and 82\% negative predictive value.CONCLUSION: B-pattern detected by a simplified lung ultrasound protocol should not preclude hemodynamically stable, sufficiently oxygenated patients from performing an SBT.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/early/2018/04/17/respcare.05817}, eprint = {https://rc.rcjournal.com/content/early/2018/04/17/respcare.05817.full.pdf}, journal = {Respiratory Care} }