Ultrasound monitoring of diaphragm thickness fraction in evaluating extubation outcome in patients undergoing mechanical ventilation / 中国医学影像技术

ABSTRACT

Objective: To observe the predictive value of diaphragmatic ultrasound for extubation outcomes in patients undergoing mechanical ventilation(MV). Methods: Totally 54 patients were ventilated mechanically more than 48 hours and ready to extubate when admitted to ICU were enrolled. During the T-tube spontaneous breathing trial (SBT), the diaphragm thickening fraction (DTF) and diaphragm thickening rapid shallow breathing index (DTF-RSBI) were measured and calculated using bedside ultrasound. Rapid shallow breathing index (RSBI) and other physiological indexes were recorded. ROC curve was used to evaluate the predictive value of DTF and DTF-RSBI for extubation. Results: There were 36 patients underwent successful (successful group) and 18 underwent failed extubation (failure group). DTF in successful group was significantly higher than that in failure group, while RBSI and DTF-RBSI in successful group were significantly lower than those in failure group (both P<0.05). Taken 28.50% as the cut-off value of DTF, the AUC for DTF was 0.702, and the sensitivity and specificity was 78.80% and 61.10%, respectively. When the cut-off value of DTF-RSBI was 72.6 breaths/(min•mm), AUC for DTF-RSBI was 0.903, the sensitivity and specificity was 100% and 72.20%, respectively. Conclusion: DTF-RSBI is more accurate than DTF and traditional RSBI, having better practical value for predicting extubation outcomes.