Preliminary Study On The Application Value Of Combined Cardiopulmonary Ultrasound In The Timing Of ECMO Weaning Oxygenation

Purpose:To explore the application value of cardiopulmonary ultrasound in predicting successful withdrawal of venous-arterial ECMO.Method:In 31 adult patients treated with VA-ECMO,the LV outflow tract velocity-time integral(LVOT VTI),Peak mitral annulus systolic(S)shortening velocity(Sm),Tei index,LVEF and pulmonary B score were measured before the weaning trial and divided into two groups according to the weaning trial outcomes,in which successful weaning was group A and failed weaning was group B.Comparing cardiopulmonary ultrasound parameters between the two groups and finding those parameters that were statistically different(p <0.05);using the weaning outcomes as the outcome variable,performed the ROC curve analysis of the successful outcome of VA-ECMO weaning trial,and obtained the best cardiopulmonary ultrasound parameters predicting VA-ECMO weaning success.Result:VTI,Sm,and LVEF in Group A were greater than group B,statistically significant(all P <0.05);Tei index and B score in Group A were higher than group B,and statistically significant(all P <0.05).There was no significant difference in LV end diastolic diameter and E / A ratio between the two groups(all P> 0.05));The value of the VTI was the highest,the AUC is 0.906,the best cut-off value is 16.07;the prediction value of other ultrasound parameters was slightly lower with the AUC of 0.859、0.813、0.787、0.766(Sm、Tei index、LVEF、B score),and the best cut-off values are 7.30、0.45、0.45、8.46(Sm、Tei index、LVEF、B score)respectively.Conclusion:Combined cardiopulmonary ultrasound has important guidance in predicting the success rate of VA-ECMO weaning.