Evaluation of role of ultrasound in assessment of successful weaning from mechanical ventilation in critically ill patients

Abstract

Background: Mechanical ventilation waning failure is a common problem, and bedside ultrasonography could be helpful in prediction of the weaning process and its results. Aim of The Work:To ssess by means of ultrasound how diaphragmatic parameters are important in predicting weaning outcome by assessing diaphragmatic thickness, diaphragmatic mobility and variation. Patients and Methods: This study included 62 mechanically ventilated patients who were subjected to transthoracic ultrasonography of the diaphragm throughout a spontaneous breathing experiment and had been divided into two groups: successful extubation and unsuccessful extubation.Results: With a p-value of <0.001, a high DE after extubation was linked to extubation success. Extubation failure was linked to lower DTF before and after extubation, with a p-value of <0.001. DE before extubation > 15 had 100% sensitivity, 85.06% specificity, 70.5 PPV and 100% NPV with p-value <0.001 for detection of extubation failure. DTF before extubation > 20.4 had 93.55% sensitivity, 93.55% specificity, 93.5% PPV, and 93.5% NPV with p-value <0.001 or detection of extubation failure. MV duration was negatively correlated with DE before extubation in the success group and positively correlated with DE after extubation in the success group. Conclusion: Diaphragm ultrasound evaluation of DTF and DE is a simple new weaning index which can be used as a bedside technique in clinical practice and has promising predictors of weaning success or failure before and after extubation.