Background and Goal of Study: 
Weaning from mechanical ventilation in intensive care is a major issue. The decision of extubation based on clinical and biological criteria has a rate of failure between 10-20%. It is then important to search for new criteria to predict better the failure or success of a respiratory withdrawal attempt. The aim of this work is to assess the relevance of the LUS score (LUNG ULTASOUND SCORE) to predict the failure or success of extubation. 
Materials and methods:  Prospective study involving intubated patients ventilated for more than 48 hours and has clinical and biological criteria for extubation. Pulmonary Ultrasound score (LUS), LVEF, report E/Ea were performed during spontaneous pressure support ventilation (PSV) and at the end of a 60 min spontaneous breathing trial (SBT). Statistical analysis was performed using IBM SPSS 20. The normality of the distributions was evaluated by performing a Kolmogorov-Smirnov. Student´s t test, Mann-Whitney test and the Wilcoxon test is used to compare the quantitative variables. Cut-Off value LUS was determined using a Receiving Operating Curve.
Results: 
Thirty-Five patients were included. Thirty-two patients have successfully passed the SBT and were extubated. Twenty-four were finally weaned at 48 hours (Group1). Eight patients (25%) were re-intubated or have benefited from a NIV before 48 hours (group 2).A statistically significant difference between groups 1 and 2 regarding age (57 ± 16 vs 31 ± 12, respectively; p = 0.002), history of COPD (85.7% vs. the 14.3%; p = 0.001. After the SBT, the reports E/A and E/Ea are significantly higher in Group 2 (2 ± 0.7 vs 1.08 ± 0.2; p = 0.021) and (10, 6 ± 2.6 vs 6.9 ± 0.5; p = 0.006). LUS score was significantly higher in Group 2, whether PSV (16.25 ± 2.1 vs 9.3 ± 3, p = 0.01) or in the SBT (19.7 ± 2 5 vs. 11.8 ± 2.6, p < 0.001).In our study, a score of LUS in TET> 16 predicted weaning failure with a sensitivity of 87.5% and a specificity of 83.3% (AUC 0.99). In COPD subgroup, the LUS score lower than 14 predict post-extubation success with a high sensitivity and specificity.
Conclusion(s): 
 The determination of the variation of pulmonary ventilation of the lung ultrasound score in the test weaning from mechanical ventilation predicted extubation failure to 48 hours especially among high-risk patients.

Lung echography as a predictive tool for extubation failure in intensive care