Background
Diaphragm ultrasound has lately been used in the prediction of successful weaning
from mechanical ventilation.
Aim
To assess diaphragm thickening fraction (DTF) and mobility measured by
ultrasound as predictors of successful weaning.
Patients and methods
This prospective study included 30 patients who were planned for weaning from
invasive mechanical ventilation. Rapid shallow breathing index was measured, and
diaphragmatic ultrasound was carried out to assess diaphragmatic excursion (DE)
and diaphragm thickening at the time of spontaneous breathing trial. Patients were
classified into two groups: group I included patients with successful weaning and
group II included patients with failed weaning.
Results
DTF was significantly higher in group I; however, there was no statistically
significant difference between the two groups regarding DE. There was a
statistically significant difference between the two groups regarding rapid
shallow breathing index, as it was higher in group II. The sensitivity, specificity,
positive predictive value, and negative predictive value for DTF at a cutoff value
more than 0.33% in prediction of successful weaning were 94, 100, 100, and 91.7%,
respectively; the corresponding values for DE at a cutoff value more than 0.91 cm
were 84, 37, 69.6, and 57.1%, respectively.
Conclusion
DTF may be useful to predict successful weaning during spontaneous breathing
trial, and it has better performance than DE.
|
