Diaphragmatic speckle tracking imaging for 2D-strain assessment in mechanical ventilation weaning test

Crognier, Laure; Poëtte, Michaël; Conil, Jean‐Marie; Lairez, Olivier; Minville, Vincent

doi:10.1016/j.mehy.2021.110593

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…However, since we focused on the ultrasound test that was supported by the most evidence of validation at the time of data collection [ 16 , 23 – 25 , 30 , 31 ], a cutaneous marker was not applied to minimize the variability of the ultrasound measurements, as described by Goligher et al [ 23 ]. In addition, advanced tools that are used to evaluate diaphragmatic function, such as tissue Doppler and speckle tracking, were not utilized [ 36 – 39 ].…”

Section: Discussionmentioning

confidence: 99%

Utilization of spontaneous breathing trial, objective cough test, and diaphragmatic ultrasound results to predict extubation success: COBRE-US trial

Varón-Vega,

Giraldo-Cadavid,

Uribe

et al. 2023

Crit Care

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Background The results of clinical and weaning readiness tests and the spontaneous breathing trial (SBT) are used to predict the success of the weaning process and extubation. Methods We evaluated the capacity of the cuff leak test, rate of rapid and shallow breathing, cough intensity, and diaphragmatic contraction velocity (DCV) to predict the success of the SBT and extubation in a prospective, multicenter observational study with consecutive adult patients admitted to four intensive care units. We used receiver operating characteristic (ROC) curves to assess the tests’ predictive capacity and built predictive models using logistic regression. Results We recruited 367 subjects who were receiving invasive mechanical ventilation and on whom 456 SBTs were performed, with a success rate of 76.5%. To predict the success of the SBT, we derived the following equation: (0.56 × Cough) − (0.13 × DCV) + 0.25. When the cutoff point was ≥ 0.83, the sensitivity was 91.5%, the specificity was 22.1%, and the overall accuracy was 76.2%. The area under the ROC curve (AUC-ROC) was 0.63. To predict extubation success, we derived the following equation: (5.7 × SBT) + (0.75 × Cough) − (0.25 × DCV) − 4.5. When the cutoff point was ≥ 1.25, the sensitivity was 96.8%, the specificity was 78.4%, and the overall accuracy was 91.5%. The AUC-ROC of this model was 0.91. Conclusion Objective measurement of cough and diaphragmatic contraction velocity could be used to predict SBT success. The equation for predicting successful extubation, which includes SBT, cough, and diaphragmatic contraction velocity values, showed excellent discriminative capacity.

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Section: Discussionmentioning

confidence: 99%

Utilization of spontaneous breathing trial, objective cough test, and diaphragmatic ultrasound results to predict extubation success: COBRE-US trial

Varón-Vega,

Giraldo-Cadavid,

Uribe

et al. 2023

Crit Care

View full text Add to dashboard Cite

show abstract

“…However, since we focused on the ultrasound test that was supported by the most evidence of validation at the time of data collection [16, 23-25, 30, 31], a cutaneous marker was not applied to minimize the variability of the ultrasound measurements, as described by Goligher et al [23]. In addition, advanced tools that are used to evaluate diaphragmatic function, such as tissue Doppler and speckle tracking, were not utilized [36][37][38][39].…”

Section: Limitationsmentioning

confidence: 99%

Objective evaluation of cough and diaphragmatic ultrasound improve the predictive capacity of spontaneous breathing test for extubation success - COBRE-US trial

Varón-Vega

Cadavid

Uribe³

et al. 2023

Preprint

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Background Use of clinical tests and ventilator weaning tests in conjunction with the spontaneous breathing test (SBT) can increase the predictive capacity of extubation success. Therefore, we assessed the predictive ability of SBT, cuff leak test, rapid-shallow-breathing-index, cough intensity, and velocity of diaphragmatic contraction (VDC) in successful weaning of mechanically ventilated patients. Methods A prospective multicenter observational study from in which consecutive adult patients admitted to 4 intensive care units. The performance of tests in discriminating between success and failure of the weaning process was assessed at different time points using ROC-curve in which the dependent variable was successful extubation. Results A total of 367 subjects who received invasive mechanical ventilation, 456 SBT were performed, with a success rate of 76.5%. The ROC curve of this model (0.52xCough)-(0.12xVDC) + 0.3 to predict a successful SBT was 0.63 (95%CI:0.60–0.65), a cut-off point > 0.84 had a sensitivity of 90.1% and a specificity of 25.3%. The ROC-curve of the model (5.7xSBT)+(0.75xCough)–(0.25xVDC)–4.5 to predict a successful extubation was 0.89 (95%CI:0.85–0.94), a cut-off point > 5.97 had a sensitivity of 98.9% and a specificity of 73.2%. The Hosmer-Lemeshow test showed no significant differences between observed and predicted values (p = 0.92). Conclusion Objective measures of cough and diaphragmatic function demonstrate excellent discriminatory ability to predict successful extubation with a cutoff of 5.97. The probability of having a successful extubation could be evaluated using the proposed model.

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“…The myocardial function can be locally analyzed and assessed using two-dimensional speckle tracking imaging. The system tracks speckle echo in high frame-rate two-dimensional pictures to calculate and describe the characteristics of myocardial mobility and deformation in the region of interest [12]. Presently, two-dimensional speckle tracking imaging technology is widely applied in evaluating the changes in cardiac function of patients with myocardial infarction, diabetes, and coronary heart disease [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Modeling of Right Ventricular Longitudinal Strain detection in Images using Statistical Analysis of Cardiac function in Severe Infantile Pneumonia by Milrinone

Hong

Chen

2023

Preprint

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After severe infantile pneumonia accompanied by heart failure, the evaluation of cardiac function using two-dimensional speckle tracking-based ultrasonic imaging technology was looked into both before and after milrinone treatment. The study’s research subjects included 82 kids with severe pneumonia and heart failure. According to therapeutic methods, they were divided into the Conv group (conventional treatment for 31 cases) and the Milrinone group (conventional treatment combined with milrinone for 31 cases). Conventional children’s ultrasonocardiography was collected to implement wavelet threshold denoising before and after treatment. The modeling was performed using statistical methods, i.e., Canny arithmetic was used to check the edge outlines of abnormal areas. Besides, the global search block matching method was utilized to monitor three consecutive cardiac cycle images. The differences between cardiac function, right ventricular longitudinal strain after two-dimensional speckle tracking imaging, serum inflammatory factors (interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, and brain natriuretic peptide (BNP)), and complication rate of children were evaluated. In comparison to Gaussian low-pass filter and mean filter techniques, the results showed that mean square error (MSE), peak signal to noise ratio (PSNR), and mean structural similarity (MSSIM) of pictures following wavelet threshold denoising were all superior. When Canny arithmetic and global search block matching were used, the cardiac speckle tracking time was 0.07 ms, and the detection accuracy was 95.5%. Compared with the Conv and Milrinone groups, normal respiration, pulmonary moist rale disappearance, and liver recovery time were all shortened (P<0.05). Besides, children’s cardiac functions, including aortic peak flow velocity, left ventricular ejection fraction, corrected ejection time, and stroke volume index, significantly increased compared with those of Conv group and Milrinone group (P<0.05). Heart rate (HR), the overall longitudinal strain of right ventricle during systole, the overall longitudinal strain of the free wall, and the overall longitudinal strain of the interventricular septum were remarkably decreased (P<0.05). Compared with the Conv and Milrinone groups, serum IL-6, IL-10, TNF-α, and BNP levels of children were remarkably reduced (P<0.05). The total complication rate of the children in Conv group and Milrinone group were 16.1% (5/31) and 3.2% (1/31), respectively. The differences between the two groups were statistically significant (P<0.05). In conclusion, two-dimensional speckle tracking imaging can benefit from employing image processing technology to improve detection precision. When used as a clinical treatment for severe infantile pneumonia and heart failure, milrinone can lower the level of inflammatory factors in children’s bodies. Furthermore, it improved children’s cardiac function, reduced complication rate, and was beneficial to the prognosis of children.

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Diaphragmatic speckle tracking imaging for 2D-strain assessment in mechanical ventilation weaning test

Cited by 3 publications

References 17 publications

Utilization of spontaneous breathing trial, objective cough test, and diaphragmatic ultrasound results to predict extubation success: COBRE-US trial

Utilization of spontaneous breathing trial, objective cough test, and diaphragmatic ultrasound results to predict extubation success: COBRE-US trial

Objective evaluation of cough and diaphragmatic ultrasound improve the predictive capacity of spontaneous breathing test for extubation success - COBRE-US trial

Modeling of Right Ventricular Longitudinal Strain detection in Images using Statistical Analysis of Cardiac function in Severe Infantile Pneumonia by Milrinone

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