الفهرس 
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Abstract
Weaning failure and long-term ventilation are linked to a higher morbidity and mortality incidence rate. The scope of this study is to identify the predictive value of the combined use of pulmonary ultrasonography and transthoracic echocardiography (TTE) in weaning failure This is a Prospective cohort observational, including fifty patients, over the age of 18 of both sexes, underwent postoperative mechanical ventilation. Lung ultrasonography (LUS) and TTE were performed before (basal) and 30 min after spontaneous breathing trial (SBT) with pressure support mode (PS) (PEEP 5 cmH2O, PS 7 cmH2O, and FIO2 0.5). Before and 30 Min after SBT, LUS score, the ratio of early peak mitral inflow velocity (E wave)/ late peak mitral inflow velocity (A wave), the ratio of (E wave) / early mitral annular displacement velocity (Ea wave), ejection fraction (EF), fluid balance and central venous pressure (CVP), were recorded. The study Result in that the LUS score was significantly increased after SBT in group WF [Mean ± SD 21±2.7 vs group WS 15.2±2.9., p-value < 0.001]. E/A and E/Ea ratio increased significantly after SBT in group WF [Mean ± SD 1.4±0.3 vs group WS 1.2 ± 0.2., p = 0.002], group WF [Mean ± SD 15.7±5.4 vs group WS 8.4±2.5., p<0.001] respectively. The LUS score and E/Ea ratio after SBT had the highest area under the curve (AUC) in the ROC curve analysis (0.917 & 0.904) respectively. The predictive value of the combined use of the LUS score and E/Ea ratio was 94.1% specificity, and 96.2% positive predictive value. No difference regarding EF, CVP, and fluid balance. We concluded that the combined use of LUS and TTE is highly predictive of weaning failure in postoperative mechanically ventilated patients.