ArticleAcute and critical care2022
Diaphragm ultrasound as a better predictor of successful extubation from mechanical ventilation than rapid shallow breathing index.
Article in Acute and critical care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06787638 (Diaphragmatic Dynamics in Laparoscopic Cholecystectomy), which is not on this map. Cited by 28 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Diaphragmatic Dynamics in Laparoscopic Cholecystectomy: Comparing Neuromuscular Blocker Reversal Strategies-A Randomized Trial
Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Association Between Diaphragm Ultrasound Measures and Extubation Outcomes in Neonates: A Systematic Review and Meta-Analysis.Pediatric pulmonology · 2026Pooled it
- Respiratory Muscle Strength and Mortality in Patients with COPD: A Systematic Review and Meta-Analysis.International journal of chronic obstructive pulmonary disease · 2025Pooled it
- Accuracy of respiratory muscle assessments to predict weaning outcomes: a systematic review and comparative meta-analysis.Critical care (London, England) · 2024Pooled it
- Effectiveness of diaphragmatic ultrasound as a predictor of successful weaning from mechanical ventilation: a systematic review and meta-analysis.Critical care (London, England) · 2023Pooled it
- Diaphragm ultrasound parameters and rapid shallow breathing index for predicting weaning failure in mechanically ventilated infants: a prospective observational PICU study.European journal of pediatrics · 2026Observational
- Diaphragmatic Ultrasound Parameters as Predictors of Weaning Success in Cervical Spinal Cord Injury.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- Application of bedside ultrasound assessment of diaphragmatic function in preparing tracheostomised patients for ventilator liberation and decannulation: a narrative review.Journal of thoracic disease · 2026Review
- Nurse-performed diaphragm ultrasound integrated with spontaneous breathing trial criteria for risk stratification of extubation outcomes in neurosurgical critically ill patients: a multicenter prospective cohort study.Frontiers in medicine · 2026Article
- Application of neurally adjusted ventilatory assist (NAVA): a narrative review.Journal of thoracic disease · 2025Review
- Ventilator-induced diaphragmatic dysfunction: pathophysiology, monitoring and advances in potential treatment and prevention.European respiratory review : an official journal of the European Respiratory Society · 2025Review
- Predicting weaning failure from invasive mechanical ventilation: The promise and pitfalls of clinical prediction scores.World journal of critical care medicine · 2025Review
- Role of ventilator and ultrasound parameters in predicting extubation success.Scientific reports · 2025Article
- Integration of Diaphragmatic Ultrasonography and Intra-Abdominal Pressure Measurement for Optimizing Weaning from Mechanical Ventilation.Risk management and healthcare policy · 2025Article
- Predictive value of bedside diaphragmatic ultrasonography for extubation success in critically ill patients after general anaesthesia: A meta-analysis with trial sequential analysis (TSA).Indian journal of anaesthesia · 2025Article
- Role of diaphragmatic ultrasound in patients with acute exacerbation of chronic obstructive pulmonary disease.World journal of clinical cases · 2024Article
- Predictors of weaning failure in ventilated intensive care patients: a systematic evidence map.Critical care (London, England) · 2024Review
- Diaphragm muscle parameters as a predictive tool for weaning critically ill patients from mechanical ventilation: a systematic review and meta-analysis study.European journal of translational myology · 2024Article
- The Role of Ultrasonography in the Process of Weaning from Mechanical Ventilation in Critically Ill Patients.Diagnostics (Basel, Switzerland) · 2024Review
- Diaphragmatic Dynamics Assessed by Bedside Ultrasound Predict Extubation in the Intensive Care Unit: A Prospective Observational Study.International journal of general medicine · 2024Article
- The ratio of respiratory rate to diaphragm thickening fraction for predicting extubation success.BMC pulmonary medicine · 2023Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 3%-19% of patients, reintubation is needed 48-72 hours following extubation, which increases intensive care unit (ICU) morbidity, mortality, and expenses. Extubation failure is frequently caused by diaphragm dysfunction. Ultrasonography can be used to determine the mobility and thickness of the diaphragm. This study looked at the role of diaphragm excursion (DE) and thickening fraction in predicting successful extubation from mechanical ventilation.
methodsThirty-one patients were extubated with the advice of an ICU consultant using the ICU weaning regimen and diaphragm ultrasonography was performed. Ultrasound DE and thickening fraction were measured three times: at the commencement of the t-piece experiment, at 10 minutes, and immediately before extubation. All patients' parameters were monitored for 48 hours after extubation. Rapid shallow breathing index (RSBI) was also measured at the same time.
resultsSuccessful extubation was significantly correlated with DE (P=0.01). Receiver curve analysis for DE to predict successful extubation revealed good properties (area under the curve [AUC], 0.83; P<0.001); sensitivity, 77.8%; specificity, 84.6%, positive predictive value (PPV), 87.5%; negative predictive value (NPV), 73.3% while cut-off value, 11.43 mm. Diaphragm thickening fraction (DTF) also revealed moderate curve properties (AUC, 0.69; P=0.06); sensitivity, 61.1%; specificity, 84.6%; PPV, 87.5%; NPV, 61.1% with cut-off value 22.33% although former one was slightly better. RSBI could not reach good receiver operating characteristic value at cut-off points 100 b/min/L (AUC, 0.58; P=0.47); sensitivity, 66.7%; specificity, 53.8%; PPV, 66.7%; NPV, 53.8%).
conclusionsTo decrease the rate of reintubation, DE and DTF are better indicators of successful extubation. DE outperforms DTF.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.