Weaning-induced cardiac dysfunction: where are we today?
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The concept of weaning-induced cardiac dysfunction emerged 26 years ago with the publication of a clinical study conducted by François Lemaire and collaborators.
One objective of this article is to remember the results and the historical context under which our pivotal study was conducted. Another objective is to review some of the subsequent studies that aimed to analyze the underlying mechanisms, to noninvasively detect the cardiac origin of weaning failure, and to propose specific therapies enabling weaning success.
Weaning-induced cardiac dysfunction has become an established cause of weaning failure. Underlying mechanisms may differ from one patient to another. Important progress has already been made in its diagnosis thanks to relevant clinical research studies. Ongoing and future technological advances in ultrasonography and in biomarker research should certainly help in diagnosing weaning induced-pulmonary edema and in identifying the main mechanisms responsible for its development. Progress on appropriate therapeutic options on an individual basis is still expected.
KeywordsWeaning Cardiac function Pulmonary edema B-type natriuretic peptide Hemoconcentration Diuretics
The author thanks Dr Sheila Myatra for her help.
Conflicts of interest
The author is a member of the medical advisory board of Pulsion Medical Systems (Germany).
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