RT Journal Article SR Electronic T1 Lung Ultrasound Prior to Spontaneous Breathing Trial Is Not Helpful in Weaning the Decision Making Process JF Respiratory Care FD American Association for Respiratory Care SP respcare.05817 DO 10.4187/respcare.05817 A1 Ana Carolina P Antonio A1 Marli M Knorst A1 Cassiano Teixeira YR 2018 UL http://rc.rcjournal.com/content/early/2018/04/17/respcare.05817.abstract AB 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 30–120 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.