Clinical Research Directory

Detecting Early Weaning-induced Pulmonary Oedema Using Lung Impedance Negative Trend During Spontaneous Breathing Trials

Sponsor: Unity Health Toronto

Summary

Critically ill patients who require a breathing machine are routinely assessed with a spontaneous breathing trial (SBT) to determine if they can safely breathe on their own. If the trial fails, the breathing machine must be continued. One common cause is weaning-induced pulmonary oedema (WIPO), in which the heart cannot handle the increased workload during spontaneous breathing, causing fluid to accumulate in the lungs. Although several markers can suggest WIPO, it is often diagnosed after the SBT has already failed. Earlier recognition could allow clinicians to treat the condition promptly, improving the success rate of subsequent trials. This study will examine whether electrical impedance tomography (EIT)-a bedside monitor that tracks how air moves in the lungs-can help identify WIPO earlier. It will focus on how lung aeration changes in the first minutes of the trial and whether combining EIT with standard clinical measurements improves early prediction of SBT outcome and identification of WIPO. Study procedures will take place during routine SBTs and are mostly non-invasive. Participants will undergo EIT monitoring, heart and lung ultrasound, ventilator measurements, and blood tests. Clinical care remains entirely according to the ICU team. Participants will be followed for up to 28 days.

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