Ultrasonographic evaluation of diaphragm thickness and excursion: correlation with weaning success in trauma patients: prospective cohort study

Golnar Sabetian; Mandana Mackie; Naeimehossadat Asmarian; Mahsa Banifatemi; Gregory A Schmidt; Mansoor Masjedi; Shahram Paydar; Farid Zand

doi:10.1007/s00540-024-03321-9

Back

Ultrasonographic evaluation of diaphragm thickness and excursion: correlation with weaning success in trauma patients: prospective cohort study

Journal article

Peer reviewed

Ultrasonographic evaluation of diaphragm thickness and excursion: correlation with weaning success in trauma patients: prospective cohort study

Golnar Sabetian, Mandana Mackie, Naeimehossadat Asmarian, Mahsa Banifatemi, Gregory A Schmidt, Mansoor Masjedi, Shahram Paydar and Farid Zand

Journal of anesthesia, Vol.38(3), pp.354-363

06/2024

DOI: 10.1007/s00540-024-03321-9

PMID: 38507058

View Online

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.

Trauma

Ventilator weaning

Diaphragm

Mechanical ventilation

Ultrasound

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 Sciences
Mandana Mackie - Shiraz University of Medical Sciences
Naeimehossadat Asmarian - Shiraz University of Medical Sciences
Mahsa Banifatemi - Shiraz University of Medical Sciences
Gregory A Schmidt - University of Iowa
Mansoor Masjedi - Shiraz University of Medical Sciences
Shahram Paydar - Shiraz University of Medical Sciences
Farid 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
NLM abbreviation: J Anesth
eISSN: 1438-8359
Language: English
Electronic publication date: 03/20/2024
Date published: 06/2024
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
Record Identifier: 9984577154502771

Metrics

6 Record Views

3 Times Cited - Web of Science

See more details