The role of diaphragmatic ultrasound as a predictor of successful extubation from mechanical ventilation in respiratory intensive care unit

Abstract Background The diaphragm muscle whose dysfunction may be very common in patients undergoing mechanical ventilation (Ferrari G, De Filippi G, Elia F, Panero F, Volpicelli G, Aprà F. Crit Ultrasound J 6:8, 2014). Aim: To evaluate real-time ultrasound in the evaluation of diaphragmatic thicken...

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Autores principales:	Randa Salah Eldin Mohamed, Abeer Salah Eldin Mahmoud, Waleed Fouad Fathalah, Mohamed Farouk Mohamed, Ahmed Aelgharib Ahmed
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Diaphragmatic thickening Extubation Diaphragmatic ultrasound Thickening fraction Excursion Diseases of the respiratory system RC705-779 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/53a2f34253ed4d038f27cc8baa3138e2
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spelling	oai:doaj.org-article:53a2f34253ed4d038f27cc8baa3138e22021-11-21T12:02:20ZThe role of diaphragmatic ultrasound as a predictor of successful extubation from mechanical ventilation in respiratory intensive care unit10.1186/s43168-021-00095-61687-84262314-8551https://doaj.org/article/53a2f34253ed4d038f27cc8baa3138e22021-11-01T00:00:00Zhttps://doi.org/10.1186/s43168-021-00095-6https://doaj.org/toc/1687-8426https://doaj.org/toc/2314-8551Abstract Background The diaphragm muscle whose dysfunction may be very common in patients undergoing mechanical ventilation (Ferrari G, De Filippi G, Elia F, Panero F, Volpicelli G, Aprà F. Crit Ultrasound J 6:8, 2014). Aim: To evaluate real-time ultrasound in the evaluation of diaphragmatic thickening, thickening fraction, and/or excursion to predict extubation outcomes. We aimed to compare these parameters with other traditional weaning measures is a fundamental. Results Out of 80 included patients, 20 (25%) have failed extubation. Diaphragmatic thickening (DT), thickening fraction (DTF), and/or excursion (DE) were significantly higher in the successful group compared to those who failed extubation (p < 0.05). Cutoff values of diaphragmatic measures associated with successful extubation (during tidal breathing) were ≥ 17 mm for DE; ≥ 2.1 cm for DT inspiration; ≥ 15.5 mm for DT expiration, functional residual capacity (FRC); and ≥ 32.82% for DTF %, giving 68%, 95%, 62%, and 90% sensitivity, respectively, and 65%, 100%, 100%, and 75% specificity, respectively. Cutoff values of diaphragmatic parameters associated with successful extubation (during deep breathing) were > 28.5 mm DT Insp, total lung capacity (TLC); >22.5mm DT Exp (RV); >37 DTF %; and > 31 mm DE, giving 100%, 73%, 97%, and 75% sensitivity and 65%, 75%, 100%, and 55% specificity, respectively. Rapid shallow breathing index (RSBI) had 47% sensitivity but 90% specificity. Conclusion Ultrasound evaluation of diaphragmatic parameters could be a good predictor of weaning in patients who passed the T-tube.Randa Salah Eldin MohamedAbeer Salah Eldin MahmoudWaleed Fouad FathalahMohamed Farouk MohamedAhmed Aelgharib AhmedSpringerOpenarticleDiaphragmatic thickeningExtubationDiaphragmatic ultrasoundThickening fractionExcursionDiseases of the respiratory systemRC705-779Medical emergencies. Critical care. Intensive care. First aidRC86-88.9ENThe Egyptian Journal of Bronchology, Vol 15, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diaphragmatic thickening Extubation Diaphragmatic ultrasound Thickening fraction Excursion Diseases of the respiratory system RC705-779 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Diaphragmatic thickening Extubation Diaphragmatic ultrasound Thickening fraction Excursion Diseases of the respiratory system RC705-779 Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Randa Salah Eldin Mohamed Abeer Salah Eldin Mahmoud Waleed Fouad Fathalah Mohamed Farouk Mohamed Ahmed Aelgharib Ahmed The role of diaphragmatic ultrasound as a predictor of successful extubation from mechanical ventilation in respiratory intensive care unit
description	Abstract Background The diaphragm muscle whose dysfunction may be very common in patients undergoing mechanical ventilation (Ferrari G, De Filippi G, Elia F, Panero F, Volpicelli G, Aprà F. Crit Ultrasound J 6:8, 2014). Aim: To evaluate real-time ultrasound in the evaluation of diaphragmatic thickening, thickening fraction, and/or excursion to predict extubation outcomes. We aimed to compare these parameters with other traditional weaning measures is a fundamental. Results Out of 80 included patients, 20 (25%) have failed extubation. Diaphragmatic thickening (DT), thickening fraction (DTF), and/or excursion (DE) were significantly higher in the successful group compared to those who failed extubation (p < 0.05). Cutoff values of diaphragmatic measures associated with successful extubation (during tidal breathing) were ≥ 17 mm for DE; ≥ 2.1 cm for DT inspiration; ≥ 15.5 mm for DT expiration, functional residual capacity (FRC); and ≥ 32.82% for DTF %, giving 68%, 95%, 62%, and 90% sensitivity, respectively, and 65%, 100%, 100%, and 75% specificity, respectively. Cutoff values of diaphragmatic parameters associated with successful extubation (during deep breathing) were > 28.5 mm DT Insp, total lung capacity (TLC); >22.5mm DT Exp (RV); >37 DTF %; and > 31 mm DE, giving 100%, 73%, 97%, and 75% sensitivity and 65%, 75%, 100%, and 55% specificity, respectively. Rapid shallow breathing index (RSBI) had 47% sensitivity but 90% specificity. Conclusion Ultrasound evaluation of diaphragmatic parameters could be a good predictor of weaning in patients who passed the T-tube.
format	article
author	Randa Salah Eldin Mohamed Abeer Salah Eldin Mahmoud Waleed Fouad Fathalah Mohamed Farouk Mohamed Ahmed Aelgharib Ahmed
author_facet	Randa Salah Eldin Mohamed Abeer Salah Eldin Mahmoud Waleed Fouad Fathalah Mohamed Farouk Mohamed Ahmed Aelgharib Ahmed
author_sort	Randa Salah Eldin Mohamed
title	The role of diaphragmatic ultrasound as a predictor of successful extubation from mechanical ventilation in respiratory intensive care unit
title_short	The role of diaphragmatic ultrasound as a predictor of successful extubation from mechanical ventilation in respiratory intensive care unit
title_full	The role of diaphragmatic ultrasound as a predictor of successful extubation from mechanical ventilation in respiratory intensive care unit
title_fullStr	The role of diaphragmatic ultrasound as a predictor of successful extubation from mechanical ventilation in respiratory intensive care unit
title_full_unstemmed	The role of diaphragmatic ultrasound as a predictor of successful extubation from mechanical ventilation in respiratory intensive care unit
title_sort	role of diaphragmatic ultrasound as a predictor of successful extubation from mechanical ventilation in respiratory intensive care unit
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/53a2f34253ed4d038f27cc8baa3138e2
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The role of diaphragmatic ultrasound as a predictor of successful extubation from mechanical ventilation in respiratory intensive care unit

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