Role of Stress-induced Diastolic Dysfunction in Weaning Failure from Mechanical Ventilation

Introduction: Critically ill patients may suffer varying degrees of myocardial dysfunction which can cause weaning failure. Stress echocardiography may be helpful in detecting silent diastolic dysfunction (DD) while weaning off mechanical ventilation [1]. Objectives: assess the existence of temporary DD during respiratory weaning using stress echocardiography. Methods: Our study was conducted on 60 ventilated patients admitted to the department of critical care, Cairo University. Stress echocardiography was done using dobutamine to assess DD and pulmonary capillary wedge pressure using E/e′ ratio. Results: a total of 34 patients (56.66%) was successfully weaned of mechanical ventilation 26 patients (43.3%) had failed weaning of mechanical ventilation. Patients with successful weaning had no statistically significant difference regarding the E/e\ ratio before and after stress testing (P value: <0.001). While patients with failed weaning had statistically significant difference regarding the E/e\ with a mean E/e\ ratio of 11.11 ± 4.44 after stress testing vs. 6.5 ±1.39 before stress testing, (P value was <0.001). Conclusion: Diastolic dysfunction is a predisposing factor for weaning failure. In addition, stress echocardiography can detect silent diastolic dysfunction during respiratory weaning.