The Role of Thoracic Fluid Content by Electrical Cardiometry and Diaphragmatic Ultrasound in Predicting Weaning Success in Patients with Pulmonary Congestion

El- Shaer, Shawky M; Abd El-Hamid, Ahmed M; Mahdy, Enas W; Amin, Samar R

doi:10.21608/bmfj.2025.381746.2395

The Role of Thoracic Fluid Content by Electrical Cardiometry and Diaphragmatic Ultrasound in Predicting Weaning Success in Patients with Pulmonary Congestion

Document Type : Review Article

Authors

¹ department of Anesthesiology, Intensive Care Faculty of Medicine- Benha University

² Department of anesthesia & intensive care, Faculty of Medicine, Benha University

³ Assistant Professor of Anesthesia & Intensive Care Faculty of Medicine - Benha University

⁴ Assistant professor of Anesthesia and Intensive Care, Faculty of Medicine, Benha University

10.21608/bmfj.2025.381746.2395

Abstract

Background: Mechanical ventilation weaning is a fundamental aspect of managing patients diagnosed with respiratory failure. Failure to wean successfully can lead to prolonged ventilation, increased morbidity, extended hospital stays, and higher mortality. Identifying reliable predictors of weaning success is therefore essential. Diaphragmatic ultrasound allows for direct assessment of diaphragmatic function and has been associated with improved weaning outcomes. Thoracic fluid content (TFC), a hemodynamic parameter measured by electrical cardiometry, reflects thoracic fluid status and inversely correlates with thoracic impedance. Elevated TFC has been linked to lung congestion and may serve as an early predictor of weaning failure. Objective: This review aims to evaluate the predictive value of TFC measured by electrical cardiometry in combination with diaphragmatic excursion assessed by ultrasound for forecasting weaning success in patients with signs of pulmonary congestion. Methods: A literature search was conducted through PubMed, Scopus, and Google Scholar using keywords including “Thoracic fluid content”, “Electrical cardiometry”, “Diaphragmatic excursion”, “Ultrasound”, and “Weaning from MV”. Articles published in English from 2000 to 2024 that investigated non-invasive predictors of weaning outcomes were reviewed. Conclusion: TFC provides a non-invasive estimate of extravascular lung water, making it a potentially valuable tool in assessing readiness for ventilator weaning. When combined with diaphragmatic ultrasound, these measures may offer a more accurate and individualized approach to predict weaning success, particularly in patients with lung congestion.

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