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Intensive Care Medicine

, Volume 40, Issue 8, pp 1069–1079 | Cite as

Weaning-induced cardiac dysfunction: where are we today?

  • Jean-Louis TeboulEmail author
My Paper 20 Years Later

Abstract

Introduction

The concept of weaning-induced cardiac dysfunction emerged 26 years ago with the publication of a clinical study conducted by François Lemaire and collaborators.

Objectives

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.

Conclusion

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.

Keywords

Weaning Cardiac function Pulmonary edema B-type natriuretic peptide Hemoconcentration Diuretics 

Notes

Acknowledgments

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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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2014

Authors and Affiliations

  1. 1.Service de réanimation médicaleHôpital de Bicêtre, Hôpitaux universitaires Paris-Sud, Assistance Publique–Hôpitaux de ParisLe Kremlin-BicêtreFrance
  2. 2.EA4533, Université Paris-SudLe Kremlin-BicêtreFrance

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