To evaluate the value of bedside multi-organ ultrasonography in the risk assessment of weaning from mechanical ventilation in critically ill patients.

A total of 72 inpatients who had received mechanical ventilation treatment and reached the clinical weaning standard in the intensive care unit of Hangzhou First People's Hospital and Hangzhou Geriatric Hospital from March 2016 to September 2017 were selected. All patients underwent bedside multi-organ ultrasonography before and after weaning. Cardiac ultrasonography was used to evaluate the indexes of cardiac structure and function. Pulmonary ultrasonography was used to detect bilateral thoracic cavity and lungs to evaluate and score the pulmonary condition. Phrenic ultrasonography was used to measure the motion amplitude, thickness, and thickening rate of the diaphragm. The results of ultrasound examination, reasons of weaning failure, and follow-up prognosis were analyzed.

Among the 72 cases with mechanical ventilation, forty six were successfully weaned from ventilation and 26 failed. Compared with the control group, the differences of left ventricular ejection fraction (LVEF), ratio of early diastolic mitral flow velocity to early diastolic mitral annulus velocity (E/e′), aortic valve velocity time integral (AOVTI), pulmonary artery systolic pressure, lung score, and the motion amplitude, thickness, and thickening rate of the diaphragm between the two groups were statistically significant (t/Z=0.65, 0.63, -4.05, 2.03, 8.32, 11.06, and 3.58, respectively; P<0.05 for all). Bedside multi-organ ultrasound was used to follow and observe the 26 patients who failed to be weaned from ventilation. Among them, three patients with diaphragmatic dysfunction showed obvious improvement in diaphragm motion amplitude and thickening rate through rehabilitation training. Pulmonary arterial pressure and pulmonary ultrasound were monitored in three patients with pulmonary arterial hypertension, and one patient was successfully weaned from ventilation 2 days after patent ductus arteriosus occlusion.

Bedside multi-organ ultrasound can be used for real-time monitoring and follow-up of patients with mechanical ventilation, thus providing a tool for the risk assessment of weaning from mechanical ventilation.