Application value of lung ultrasound combined with ultrasound cardiac output monitor in the weaning of invasive mechanical ventilation for elderly patients in ICU
FAN Zhiwen
HU Lizhi
SUN Weilan
ZE Hao
TANG Yan
Abstract：Objective To explore the application value of lung ultrasound score combined with Ultrasound cardiac output monitor in the weaning of invasive mechanical ventilation for elderly patients in the ICU.Methods A total of 60 elderly patients receiving mechanical ventilation admitted to Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University between April 2023 and June 2024 were selected,including 36 males and 24 females,with an average age of(71.81±8.19)years,ranging from 65 to 89 years.the weaning outcomes were recorded 48 hours after extubation.Based on the weaning results,the patients were divided into a extubation success group and a extubation failure group.The differences in lung ultrasound scores and Ultrasound cardiac output monitor examination indicators(such as cardiac output,cardiac index,and Smith-Madigan inotropic index)between the extubation success group and the extubation failure group were compared.The receiver operating characteristic curve was used to evaluate the predictive value of lung ultrasound scores and Ultrasound cardiac output monitor examination indicators(such as cardiac output,cardiac index,and Smith-Madigan inotropic index)for the weaning outcomes of elderly mechanically ventilated patients.Results Among the 60 patients,the extubation success group comprised 42 cases,while the extubation failure group included 18 cases.The lung ultrasound score in the extubation success group was significantly lower than that in the extubation failure group,with a statistically significant difference(P<0.05).The cardiac index and Smith-Madigan inotropic index in the extubation success group were significantly higher than those in the extubation failure group,with statistically significant differences(P<0.05).However,there was no statistically significant difference in cardiac output between the two groups(P>0.05).The receiver operating characteristic curve was used to evaluate the predictive efficacy of lung ultrasound score,cardiac index,and Smith-Madigan inotropic index for weaning.The AUC value for lung ultrasound score was 0.785,with a cutoff value of 16.5 points,a sensitivity of 77.8%,and a specificity of 71.4%.The AUC value for cardiac index was 0.700,with an optimal cutoff value of 2.15,a sensitivity of 44.4%,and a specificity of 92%.The AUC value for Smith-Madigan inotropic index was 0.817,with a cutoff value of 1.15,a sensitivity of 83.3%,and a specificity of 64.3%.The combined AUC value for the three indicators was 0.893,with a sensitivity of 78.6%and a specificity of 94.4%.Further comparison showed no statistically significant difference in AUC values between the combined assessment of the three indicators and the Smith-Madigan inotropic index alone(P>0.05).However,the AUC value of the combined assessment was significantly higher than those of the lung ultrasound score and cardiac index individually,with statistically significant differences(P<0.05).Conclusion Lung ultrasound scores,along with cardiac index and Smith-Madigan inotropic index measured by ultrasonic cardiac output monitoring,all hold high predictive value for successful extubation in elderly patients undergoing invasive mechanical ventilation,the predictive efficacy of combining these three indicators does not show a clear advantage compared to Smith-Madigan inotropic index alone.
Keywords：lung ultrasoundultrasound cardiac output monitormechanical ventilationweaning
Publication Date：2026-01-25
Online Publishing Date：2026-03-03(First online date of this platform, not the publication date of the document)
Pages：6( 25-30 )