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Objective: This prospective cohort study was designed to assess the rule of myocardial performance (Tei) index and NT-Pro BNP serum levels in prediction of weaning failure in mechanically ventilated COPD patients. Methods: Forty patients with respiratory failure due to acute exacerbation of COPD were enrolled to this study. All patients underwent a comprehensive echocardiographic examination including tissue doppler imaging within first 12 hours of admission. NT-pro BNP serum levels were measured on admission. Patients were followed up for outcome of weaning failure. Results: Right ventricular Tei index was higher in patients with failed weaning in comparison to successfully weaned patients (mean 0.66 versus 0.36, P < 0.001), also left ventricular Tei index was higher in patients who failed to be weaned (mean 0.45 versus 0.36, P = 0.007). There was no difference in serum NT-Pro BNP between successfully weaned patients and patients with weaning failure. Right ventricular Tei index showed higher accuracy in predicting weaning failure than the left ventricular Tei index (AUC 0.932 versus 0.754), while serum NT-Pro BNP showed no discrimination in predicting weaning failure (AUC 0.556). Conclusion: Tei index was superior to NT-ProBNP in prediction of weaning failure in COPD patients.

Tei Index versus Pro BNP as Predictors of Weaning Failure in Mechanically Ventilated Chronic Obstructive Pulmonary Disease Patients