الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Acute cardiogenic pulmonary oedema results from any pathological condition leading to inability of the left ventricle to handle the pulmonary venous return.
The development of ventilatory support devices, has played a decisive role in the treatment of Acute Respiratory failure ARF secondary to ACPE. The initial management of patients presenting with acute cardiogenic pulmonary edema (ACPE) should address the ABCs of resuscitation, i.e., airway, breathing, and circulation. Good oxygenation should be given to maintain oxygen saturation more than 90%. Early weaning from the ventilator prevents complications such as ventilator-associated pneumonia, loss of respiratory muscle strength, and the complications of prolonged ventilation and intubation. A bedside echocardiogram in a mechanically ventilated patient with decompensated HF is an important diagnostic tool in determining the etiology of pulmonary edema and to help in assessment of readiness to weaning.
Our study was conducted to evaluate the role of Transthoracic Echocardiography as a diagnostic tool during weaning from mechanical ventilation in patients suffering from acute cardiogenic pulmonary oedema.
The study was conducted on 51 patients admitted to intensive care units in Alexandria University presenting with acute cardiogenic pulmonary oedema and mechanically ventilated.
Cardiovascular dysfunction is an important cause or contributor to weaning failure. Early identification of high-risk patients for weaning failure of cardiovascular origin and accurate diagnosis is crucial, as targeted treatment according to the underlying mechanism might help the heart to tolerate more effectively the burden of weaning process.
The present study showed that in successfully weaned patients the value of E/e’ was significantly decreased during the follow up while DT increased.
Transthoracic echocardiography with measurement of the E/e’ ratio can identify patients at risk of weaning failure at the bedside. A reduced LVEF did seem to influence the weaning outcome.