title: Ultrasonography evaluation during the weaning process: the heart, the diaphragm, the pleura and the lung.
abstract: OBJECTIVE
  On a regular basis, the intensivist encounters the patient who is difficult to wean from mechanical ventilatory support. The causes for failure to wean from mechanical ventilatory support are often multifactorial and involve a complex interplay between cardiac and pulmonary dysfunction. A potential application of point of care ultrasonography relates to its utility in the process of weaning the patient from mechanical ventilatory support.
  
  
  METHODS
  This article reviews some applications of ultrasonography that may be relevant to the process of weaning from mechanical ventilatory support.
  
  
  RESULTS
  The authors have divided these applications of ultrasonography into four separate categories: the assessment of cardiac, diaphragmatic, and lung function; and the identification of pleural effusion; which can all be evaluated with ultrasonography during a dynamic process in which the intensivist is uniquely positioned to use ultrasonography at the point of care.
  
  
  CONCLUSIONS
  Ultrasonography may have useful application during the weaning process from mechanical ventilatory support.
authors.affiliation: North Shore/LIJ Medical Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Hofstra NorthShore-LIJ School of Medicine, Hempstead, NY, 11549, USA. mayosono@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Mayo
authors.affiliation: Department of Emergency Medicine, San Luigi Gonzaga University Hospital, 10043, Orbassano, Torino, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Volpicelli
authors.affiliation: Département de Réanimation Médicale et de Médecine Hyperbare, CHU Angers et UFR Santé Angers, Université Angers, Angers, France.
authors.forename: N
authors.initials: N
authors.lastname: Lerolle
authors.affiliation: Respiratory Intensive Care Unit, Salvatore Maugeri Foundation, 27100, Pavia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Schreiber
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Albany Medical Center, 47 New Scotland Ave, Albany, NY, 12208, USA.
authors.forename: P
authors.initials: P
authors.lastname: Doelken
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Hôpital Ambroise Paré, Service de Réanimation, Pôle Thorax-Maladies Cardiovasculaires-Abdomen-Métabolisme, 92104, Boulogne-Billancourt, France.|INSERM U-1018, CESP, Equipe 5 (EpReC, Epidémiologie Rénale et Cardiovasculaire), 94807, Villejuif, France.|Université de Versailles Saint-Quentin en Yvelines, UFR des Sciences de la Santé Simone Veil, 78280, Saint-Quentin en Yvelines, France.
authors.forename: A
authors.initials: A
authors.lastname: Vieillard-Baron
mesh_terms: D003964:Diaphragm / Q000502:physiology*; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D010994:Pleura / Q000503:physiopathology*; D019095:Point-of-Care Systems; D014463:Ultrasonography; D015300:Ventilator Weaning
keywords: Cardiac function; Echocardiography; Ultrasonography; Weaning