Bedet A, Tomberli F, Prat G, et al. - Given that one of the main mechanisms of weaning failure during mechanical ventilation is weaning-induced cardiac pulmonary edema (WiPO), and therefore, whether weaning-induced cardiac ischemia contributes to weaning failure from cardiac origin, was investigated in this prospective cohort study run in 4 intensive care units, including patients mechanically ventilated for at least 24 h who failed a first spontaneous breathing trial (SBT). Researchers used echocardiography, continuous 12-lead ST monitoring, biomarkers to explore patients during a second SBT in order to gauge the mechanisms of weaning failure. The occurrence of WiPO among patients who failed a first SBT was reported in 124/208 (59.6%) patients according to the liberal definition and in 44/208 (21.2%) patients based on the conservative definition. In this observational study, pulmonary edema commonly occurred in mechanically ventilated patients who failed a first SBT but demonstrated a weak link with cardiac ischemia and weaning outcomes.