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| The Predictive Value of Diaphragmatic Ultrasound for Weaning from Mechanical Ventilation in Obese Patients |
| ZHAO Yonghua, JIN Lizhen, YU Qiaoqing, et al |
| Langfang People's Hospital, Hebei Langfang 065000, China |
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Abstract Objective: To evaluate the performance of diaphragmatic excursion-time index to predict the outcome of extubation. Methods: This was a prospective observation study. Respiratory rate and tidal volume were recorded at the end of spontaneous breathing trial (SBT). Both M-Mode and B-Mode ultrasonography were used to assess the right diaphragmatic displacement. Meanwhile, duration of mechanical ventilation, length of stay in ICU and outcome of the weaning were recorded. The receiver operator characteristic curves were used to evaluate the diagnostic accuracy of diaphragmatic E-T index measured during a spontaneous breathing trial and changes between A/C and SBT in diaphragm excursion, TI, and diaphragmatic E-T index. Results: During SBT, DE, Ti,E-T index in the successful weaning group were higher than those in the weaning group (P<0.05), duration of mechanical ventilation was shorter than those in the failure weaning group(P<0.05). ΔDE,ΔTi andΔE-T index in the successful weaning group was statistically different from the failure weaning group (p<0.05). The area under the ROC curve of E-T index measured during a spontaneous breathing trial was 0.78(95%CI:0.59-0.96),the optimal thresholds were 1.02(cm·s)with a sensitivity of 75% and a specificity of 85%. The area under the ROC curve of E-T index during transition from A/C to SBT was 0.82(95%CI:0.68~0.92),the optimal thresholds were -0.20(cm·s)with a sensitivity of 87.5% and a specificity of 75%. Conclusion: Diaphragm E-T index measured during SBT may help predict the outcome of extubation increase in diaphragm E-T index between A/C and SBT increases the likelihood of successful extubation.
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2021, Vol. 27 
