Diaphragm and Lung Ultrasound Indices in Prediction of Outcome of Weaning from Mechanical Ventilation in Pediatric Intensive Care Unit

被引:54
作者
Abdel Rahman, Dalia A. [1 ]
Saber, S. [2 ]
El-Maghraby, A. [2 ]
机构
[1] Zagazig Univ, Sednawy Hosp, Dept Pediat, Fac Med, Zagazig, Egypt
[2] Zagazig Univ, Sednawy Hosp, Dept Radiol, Fac Med, Zagazig, Egypt
关键词
Diaphragmatic and lung ultrasound; Mechanical ventilation; Pediatric intensive care unit; Weaning failure; EXTUBATION;
D O I
10.1007/s12098-019-03177-y
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective To predict the added value of diaphragmatic and lung ultrasound indices (US) in anticipation of the outcome of mechanical ventilation of pediatric patients in the intensive care unit. Methods This prospective study was conducted in Zagazig University, Pediatric Hospitals, PICU; Egypt. One hundred six mechanically ventilated children aged between 1 mo to 170 mo were included in the study. All patients were candidates for weaning and have been given a chance for spontaneous breathing trial (SBT), during which diaphragmatic and lung US was performed for them. The diaphragm thickening fraction (DTF), the diaphragmatic excursion and the lung US score (LUS), that included 4 US aeration forms, were assessed. Results There were statistically significant differences between patients with failed weaning and those with successful weaning regarding DTF, diaphragmatic excursion and LUS (p < 0.001). The best cut-off value of DTF, diaphragmatic excursion, and LUS for predicting weaning failure was >= 23.175%, >= 6.2 mm, and >= 12 with an AUC (area under curve) of 0.932, 0.876, and 0.934, respectively. Conclusions Diaphragmatic and lung US add a quick, accurate and non-invasive indices to the weaning readiness parameters compared to the other standard parameters alone. So, it is recommended to be added to the predictive parameters of weaning outcome.
引用
收藏
页码:413 / 420
页数:8
相关论文
共 20 条
[1]  
Pérez-Calatayud AA, 2016, GAC MED MEX, V152, P304
[2]  
Baess A I., Egypt J Bronchol, DOI DOI 10.4103/1687-8426.184370
[3]   Diaphragm ultrasound as a predictor of successful extubation from mechanical ventilation [J].
DiNino, Ernest ;
Gartman, Eric J. ;
Sethi, Jigme M. ;
McCool, F. Dennis .
THORAX, 2014, 69 (05) :423-427
[4]   Simplified lung ultrasound protocol shows excellent prediction of extravascular lung water in ventilated intensive care patients [J].
Enghard, Philipp ;
Rademacher, Sibylle ;
Nee, Jens ;
Hasper, Dietrich ;
Engert, Ulrike ;
Joerres, Achim ;
Kruse, Jan M. .
CRITICAL CARE, 2015, 19
[5]   Diaphragm ultrasound as a new index of discontinuation from mechanical ventilation [J].
Ferrari G. ;
De Filippi G. ;
Elia F. ;
Panero F. ;
Volpicelli G. ;
Aprà F. .
Critical Ultrasound Journal, 2014, 6 (1) :1-6
[6]  
Jabaudon M, 2012, AM J RESP CRIT CARE, V185, pA3093
[7]   Differences in Clinical Outcomes According to Weaning Classifications in Medical Intensive Care Units [J].
Jeong, Byeong Ho ;
Ko, Myeong Gyun ;
Nam, Jimyoung ;
Yoo, Hongseok ;
Chung, Chi Ryang ;
Suh, Gee Young ;
Jeon, Kyeongman .
PLOS ONE, 2015, 10 (04)
[8]   Pediatric extubation readiness tests should not use pressure support [J].
Khemani, Robinder G. ;
Hotz, Justin ;
Morzov, Rica ;
Flink, Rutger C. ;
Kamerkar, Asvari ;
LaFortune, Marie ;
Rafferty, Gerrard F. ;
Ross, Patrick A. ;
Newth, Christopher J. L. .
INTENSIVE CARE MEDICINE, 2016, 42 (08) :1214-1222
[9]   Diaphragm dysfunction assessed by ultrasonography: Influence on weaning from mechanical ventilation [J].
Kim, Won Young ;
Suh, Hee Jung ;
Hong, Sang-Bum ;
Koh, Younsuck ;
Lim, Chae-Man .
CRITICAL CARE MEDICINE, 2011, 39 (12) :2627-2630
[10]   Ultrasonography evaluation during the weaning process: the heart, the diaphragm, the pleura and the lung [J].
Mayo, P. ;
Volpicelli, G. ;
Lerolle, N. ;
Schreiber, A. ;
Doelken, P. ;
Vieillard-Baron, A. .
INTENSIVE CARE MEDICINE, 2016, 42 (07) :1107-1117