Journal article
Ultrasonographic evaluation of diaphragm thickness and excursion: correlation with weaning success in trauma patients: prospective cohort study
Journal of anesthesia, Vol.38(3), pp.354-363
03/20/2024
DOI: 10.1007/s00540-024-03321-9
PMID: 38507058
Abstract
Prolonged mechanical ventilation (MV) subjects multiple trauma patients to ventilator-induced diaphragmatic dysfunction. There is limited evidence on the predictive role of diaphragm ultrasound (DUS) for weaning success in multiple trauma patients. Therefore, we evaluated Ultrasound of the diaphragm as a valuable indicator of weaning outcomes, in trauma patients.
This prospective cohort study included 50 trauma patients from September 2018 to February 2019. DUS was performed twice: upon ICU admission and the first weaning attempt. The diagnostic accuracy of indexes was evaluated by ROC curves.
The study included patients with a mean age of 35.4 ± 17.37, and 78% being male. The median injury severity score was 75 (42-75). The failure group exhibited significantly lower right diaphragmatic excursion (DE) compared to the success group (P = 0.006). In addition, the failure group experienced a significant decrease in both right and left DE from admission to the first attempt of weaning from MV (P < 0.001). Both groups showed a significant decrease in inspiratory and expiratory thickness on both sides during weaning from MV compared to the admission time (P < 0.001). The findings from the ROC analysis indicated that the Rapid shallow breathing index (RSBI) (Sensitivity = 91.67, Specificity = 100), respiratory rate (RR)/DE (Right: Sensitivity = 87.5, Specificity = 92.31), and RR/TF (Thickening Fraction) (Right: Sensitivity = 83.33, Specificity = 80.77) demonstrated high sensitivity and specificity in predicting weaning outcome.
In the context of patients with multiple trauma, employing DUC and assessing diaphragmatic excursion, thickness, RR/DE index, RR/TF index, and RSBI can aid in determining successful ventilator weaning.
Details
- Title: Subtitle
- Ultrasonographic evaluation of diaphragm thickness and excursion: correlation with weaning success in trauma patients: prospective cohort study
- Creators
- Golnar Sabetian - Shiraz University of Medical SciencesMandana Mackie - Shiraz University of Medical SciencesNaeimehossadat Asmarian - Shiraz University of Medical SciencesMahsa Banifatemi - Shiraz University of Medical SciencesGregory A Schmidt - University of IowaMansoor Masjedi - Shiraz University of Medical SciencesShahram Paydar - Shiraz University of Medical SciencesFarid Zand - Shiraz University of Medical Sciences
- Resource Type
- Journal article
- Publication Details
- Journal of anesthesia, Vol.38(3), pp.354-363
- DOI
- 10.1007/s00540-024-03321-9
- PMID
- 38507058
- eISSN
- 1438-8359
- Language
- English
- Electronic publication date
- 03/20/2024
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984577154502771
Metrics
4 Record Views