The Predictive Value of Lung Ultrasound in Weaning Failure: A Meta-Analysis of Current Evidence

Introduction: Weaning from mechanical ventilation remains a critical step in patient recovery within the ICU, and lung ultrasound (LUS) is increasingly used to assess readiness. This meta-analysis evaluates the predictive value of LUS findings for weaning outcomes, focusing on identifying failure risks and enhancing weaning success.

Methods: A systematic review of studies from 2010 to 2023 was conducted using PubMed, Embase, and Cochrane Library databases. Studies were included if they reported LUS parameters predicting weaning success or failure in ventilated patients. Data were analyzed using Python and R, with pooled effect sizes calculated for predictive accuracy, and heterogeneity assessed via I² statistics.

Results: From 1,352 screened articles, 29 studies met the inclusion criteria, encompassing 7,830 patients. Meta-analysis revealed that LUS scores were significantly associated with weaning outcomes. Higher LUS aeration scores correlated with increased weaning failure risk (RR: 1.42, 95% CI: 1.29-1.58, p < 0.001). Sensitivity and specificity for predicting weaning failure were 0.85 (95% CI: 0.80-0.89) and 0.78 (95% CI: 0.72-0.83), respectively.

Conclusion : Lung ultrasound is a valuable, non-invasive tool for predicting weaning outcomes, offering significant insights into patient readiness and reducing unnecessary extubation attempts. This review supports incorporating LUS into standard weaning assessments to improve patient management and outcomes in critical care. Further research on standardizing LUS scoring may enhance its predictive reliability.