B-line by Lung Ultrasound as a Predictor of Re-intubation in Mechanically Ventilated Patients with Heart Failure

Abstract

Abstract There have been few studies on predictors of weaning failure from mechanical ventilation (MV) in patients with heart failure (HF). We sought to investigate the predictive value of B-lines measured by lung ultrasound (LUS) on the risk of re-intubation after MV weaning and in-hospital outcomes. This was a single-center, prospective observational study that included HF patients who were on invasive MV. LUS was performed right before ventilator weaning. A positive exam for B-lines was defined as the observation of two or more regions that had three or more numbers of B-lines located bilaterally on the thorax. Early re-intubation with 72 hours after MV weaning was significantly higher in the positive B-line group (14.1%) than the negative B-line group (2.4%) (p=0.011). The rate of total re-intubation during admission (p=0.004), duration of intensive care unit stay (p=0.004), and hospital stay (p=0.010) were greater in the positive B-line group. The negative predictive value (NPV) of positive B-lines was 97.6% for the primary outcome. B-lines measured by LUS can predict the risk of re-intubation after MV weaning. Considering the high NPV of positive B-lines, it may help guide the decision of extubation in patients on invasive MV due to acute decompensated HF.