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Diaphragmatic Excursion Assessment by Ultrasound versus Volume Associated Weaning Parameters as A Prediction in Extubation in Critically Ill Patients

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Last updated: 24 Dec 2024

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Abstract

Background: Liberating a patient from ventilator is a continuous process as with any disease condition which starts with recognition of patient being ready to be weaned from ventilator by letting the patient breathe on T-piece and, if successful proceeding to SBT followed by extubation, if it is tolerated well (simple weaning). Otherwise letting patient on ventilator till next such trial being successful. Difficulty in weaning from mechanical ventilation is one of the most frequently encountered problems in MICU. An estimated 20% of mechanically ventilated patients face failed extuabtion (requiring reintubation within 48 h of extuabtion).
Aim of the study: This study was designed to assess the value of the excursion of diaphragm tested by ultrasonography to predict weaning from mechanical ventilation versus volume associated weaning parameters in medical intensive unit's patients.
Patients and Methods: A prospective study was carried out on 30 patients ready for weaning. All patients were divided into two equal groups.Group A (successful weaning group) and Group B (failed weaning group).
Results: Of the entire group of 30 patients, 21 patients (70%) had succeeded extubation and 9 patients (30%) failed. By applying cut-off level 1cm determined in our study the sensitivity and specificity of mean liver and spleen displacement were 95.2% and 88.9% respectively, which is higher than Pi max (85.7% and 77.8%) by cut-off level ≤ 20 cm H2o, ƒ/VT (85.7% and 66.7%) by cut-off level ≤ 105 breath/min/l.
Conclusions: The present study concluded that ultrasonographic measurement of liver and spleen displacement during SBT before extubation is a good method for predicting extubation outcome.Ke

DOI

10.21608/ejhm.2018.9063

Keywords

Bedside ultrasonography, Critically Ill, Diaphragmatic dysfunction

Authors

First Name

Mohamed Ahmed Abdel Hamid Shaalan, Gamal Ali Badr ,Atef Abou Elfotouh Ibrahim,

Last Name

Amr Ahmed Mostafa

MiddleName

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Affiliation

The Department of Internal Medicine, Faculty of Medicine, Al-Azhar University,Cairo, Egypt

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Orcid

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Volume

72

Article Issue

2

Related Issue

1774

Issue Date

2018-07-01

Receive Date

2018-04-14

Publish Date

2018-07-01

Page Start

3,873

Page End

3,878

Print ISSN

1687-2002

Online ISSN

2090-7125

Article File

EJHM_Volume 72_Issue 2_Pages 3873-3878.pdf

PDF . 299.5kB

Link

https://ejhm.journals.ekb.eg/article_9063.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=9063

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3

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Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Diaphragmatic Excursion Assessment by Ultrasound versus Volume Associated Weaning Parameters as A Prediction in Extubation in Critically Ill Patients

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Article

Created At

22 Jan 2023