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366697

Value of diaphragmatic ultrasound in predicting failure of weaning from mechanical ventilation

Article

Last updated: 28 Dec 2024

Subjects

-

Tags

Healthcare research

Abstract

Background: Diaphragmatic dysfunction was reported in most of mechanically ventilated patients and is considered one of the contributing factors of difficult weaning. Several parameters such as respiratory rate (RR), Tidal volume (TV), and rapid shallow breathing index (RSBI), are used as predictors of liberation failure from mechanical ventilation. The aim of the study was to investigate diaphragmatic dysfunction as an index of failure of liberation from mechanical ventilation and compare it with other conventional predictors of failure of weaning. Methods: 56 patients on invasive mechanical ventilation, admitted to our respiratory intensive care unit from November 2021 to May 2023, were included. Bedside chest ultrasound was done 30 minutes after starting spontaneous breathing trial. We recorded chest ultrasound indices; diaphragmatic excursion (DE) at inspiration (DE-insp) and forced inspiration (DE-forced-insp) and diaphragmatic thickness at inspiration (Tdi-insp) and expiration (Tdi-exp) and diaphragmatic thickening fraction (DTF). We compared these indices with predictors of weaning as TV, RR, RSBI, PaO2, PaO2/FiO2 ratio, and Total leucocytic count (TLC). Results: liberation failure from mechanical ventilation was detected in thirty cases (53.57 %). Also, those who failed weaning had significantly lower PaO2, pH, TV and significantly higher RSBI, RR, and TLC. As regard chest Ultrasound findings, patients with weaning failure had significantly lower DTF, Tdi-insp, and Tdi-exp. The sensitivity, specificity, negative predictive value, and positive predictive value of the diaphragmatic indices were all recorded and shown in tables. Conclusion: diaphragmatic dysfunction is considered an obstacle to weaning. Ultrasound diaphragmatic thickness is a better predictor of weaning failure than diaphragmatic excursion.

DOI

10.21608/mjmr.2023.219440.1440

Keywords

Keywords: Diaphragmatic thickening fraction, Mechanical Ventilation, Weaning Failure, Chest Ultrasound, diaphragmatic excursion

Authors

First Name

Mohammed

Last Name

Abdelfatah

MiddleName

Taha

Affiliation

Department of chest disease, Faculty of Medicine, Minia University, Minia, Eygypt

Email

mohamed_taha@mu.edu.eg

City

Minya

Orcid

-

First Name

Miral

Last Name

Al-sherif

MiddleName

-

Affiliation

Department of chest disease, Faculty of Medicine, Minia University, Minia, Eygypt

Email

miral.83@hotmail.com

City

Minya

Orcid

-

First Name

Radwa

Last Name

Mohammed

MiddleName

Kamal

Affiliation

Department of chest disease, Faculty of Medicine, Minia University, Minia, Eygypt

Email

radwakamal232@gmail.com

City

Minya

Orcid

-

First Name

Ahmed

Last Name

Mady

MiddleName

Fathey

Affiliation

Department of chest disease, Faculty of Medicine, Minia University, Minia, Eygypt

Email

ahmed.mady@mu.edu.eg

City

Minya

Orcid

-

Volume

34

Article Issue

4

Related Issue

45686

Issue Date

2023-10-01

Receive Date

2023-06-27

Publish Date

2023-10-01

Page Start

214

Page End

226

Online ISSN

2682-4558

Link

https://mjmr.journals.ekb.eg/article_366697.html

Detail API

https://mjmr.journals.ekb.eg/service?article_code=366697

Order

366,697

Type

Original Article

Type Code

2,212

Publication Type

Journal

Publication Title

Minia Journal of Medical Research

Publication Link

https://mjmr.journals.ekb.eg/

MainTitle

Value of diaphragmatic ultrasound in predicting failure of weaning from mechanical ventilation

Details

Type

Article

Created At

28 Dec 2024