Academic Journal
Diaphragmatic Dynamics and Thickness Parameters Assessed by Ultrasonography Predict Extubation Success in Critically Ill Patients
| Title: | Diaphragmatic Dynamics and Thickness Parameters Assessed by Ultrasonography Predict Extubation Success in Critically Ill Patients |
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| Authors: | Marlon Adrián Laguado-Nieto, Sandra Liliana Roberto-Avilán, Francisco Naranjo-Junoy, Héctor Julio Meléndez-Flórez, Ivan David Lozada-Martinez, Gonzalo Andrés Domínguez-Alvarado, Víctor Alfonso Campos-Castillo, Sergio Uriel Ríos-Orozco, Alexis Rafael Narváez-Rojas |
| Source: | Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine, Vol 17 (2023) |
| Publisher Information: | SAGE Publishing, 2023. |
| Publication Year: | 2023 |
| Collection: | LCC:Diseases of the circulatory (Cardiovascular) system LCC:Diseases of the respiratory system |
| Subject Terms: | Diseases of the circulatory (Cardiovascular) system, RC666-701, Diseases of the respiratory system, RC705-779 |
| More Details: | INTRODUCTION A frequent cause of weaning and extubation failure in critically ill mechanically ventilated patients is diaphragm muscle dysfunction. Ultrasound (US) evaluation of the diaphragm yields important data regarding its thickness (diaphragm thickening fraction [TFdi]) and its movement or excursion (diaphragmatic dynamics) that reveal the presence of diaphragmatic dysfunction. METHODS Cross-sectional study, which included patients older than 18 years with invasive mechanical ventilation with an expected duration of more than 48 h, in a tertiary referral center in Colombia. The excursion of the diaphragm, inspiratory and expiratory thickness, and TFdi were evaluated by US. Prevalence and use of medications were evaluated, and the association with failure in ventilatory weaning and extubation was analyzed. RESULTS Sixty-one patients were included. The median age and APACHE IV score were 62.42 years and 78.23, respectively. The prevalence of diaphragmatic dysfunction (assessed by excursion and TFdi) was 40.98%. The sensibility, specificity, positive predictive value, and negative predictive value for TFdi 20%) allow in its set and with normal values, predict success or failure for the extubation with an area under the ROC curve of 0.87. CONCLUSION Diaphragmatic dynamics and thickness parameters together assessed by ultrasonography could predict the success of extubation in critically ill patients in Colombia, based on the finding of diaphragmatic dysfunction. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 1179-5484 11795484 |
| Relation: | https://doaj.org/toc/1179-5484 |
| DOI: | 10.1177/11795484231165940 |
| Access URL: | https://doaj.org/article/3c6c5750aeee4373bbba07f8285c3872 |
| Accession Number: | edsdoj.3c6c5750aeee4373bbba07f8285c3872 |
| Database: | Directory of Open Access Journals |
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| ISSN: | 11795484 |
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| DOI: | 10.1177/11795484231165940 |
| Published in: | Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine |
| Language: | English |