Diaphragmatic Excursion Assessment by Ultrasound versus Volume Associated Weaning Parameters as A Prediction in Extubation in Critically Ill Patients
Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 72, Issue 2
Abstract
<span>Background</span><span>: Liberating a patient from ventilator is a continuous process as with any disease condition which starts with recognition of patient being ready to be weaned from ventilator by letting the patient breathe on T-piece and, if successful proceeding to SBT followed by extubation, if it is tolerated well (simple weaning)</span><span>. </span><span>Otherwise letting patient on ventilator till next such trial being successful. Difficulty in weaning from mechanical ventilation is one of the most frequently encountered problems in MICU. An estimated 20% of mechanically ventilated patients face failed extuabtion (requiring reintubation within 48 h of extuabtion).<br /> </span><span>Aim of the study</span><span>: This study was designed to assess the value of the excursion of diaphragm tested by ultrasonography to predict weaning from mechanical ventilation versus volume associated weaning </span><span>parameters in medical intensive unit’s patients.<br /> </span><span>Patients and Methods: </span><span>A prospective study was carried out on 30 patients ready for weaning. All patients were divided into two equal groups.Group A (successful weaning group) and Group B (failed weaning group).<br /> </span><span>Results: </span><span>Of the entire group of 30 patients, 21 patients (70%) had succeeded extubation and 9 patients (30%) failed. By applying cut-off level 1cm determined in our study the sensitivity and specificity of mean liver and spleen displacement were 95.2% and 88.9% respectively, which is higher than Pi max (85.7% and 77.8%) by cut-</span><span>off level ≤ 20 cm H2o, ƒ/VT (85.7% and 66.7%) by cut</span><span>-</span><span>off level ≤ 105 breath/min/l.<br /> </span><span>Conclusions</span><span>: </span><span>The present study concluded that ultrasonographic measurement of liver and spleen displacement during SBT before extubation is a good method for predicting extubation outcome.</span><span>Ke </span>
Authors and Affiliations
Eman Helal
Keywords
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- EP ID EP584054
- DOI 10.21608/ejhm.2018.9063
- Views 109
- Downloads 0
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