Observational studyBMC pulmonary medicine2022
Diaphragmatic ultrasonography-based rapid shallow breathing index for predicting weaning outcome during a pressure support ventilation spontaneous breathing trial.
Observational study in BMC pulmonary medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 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.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Predictive value of diaphragmatic ultrasound for weaning outcomes in mechanically ventilated patients with acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis.Critical care (London, England) · 2026Pooled it
- Accuracy of respiratory muscle assessments to predict weaning outcomes: a systematic review and comparative meta-analysis.Critical care (London, England) · 2024Pooled it
- Comparison of standardized diaphragm ultrasound measurement and conventional methods for predicting weaning failure: a prospective observational study.Journal of anesthesia · 2026Observational
- Midaxillary-to-midclavicular diaphragmatic mobility ratio predicts weaning success in invasive mechanical ventilation: an observational cohort study.Quantitative imaging in medicine and surgery · 2026Article
- Article
- Bedside Diaphragm and Lung Ultrasound for Predicting Liberation from Mechanical Ventilation: A Systematic Review with Clinical Synthesis.Journal of clinical medicine · 2026Review
- 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
- Weaning failure from mechanical ventilation: a scoping review of the utility of ultrasonography in the weaning process.British journal of anaesthesia · 2025Article
- Clinical utility of diaphragmatic ultrasound for mechanical ventilator liberation in adults: a systematic review and meta-analysis.Journal of intensive care · 2025Article
- Ultrasound-based abdominal muscles and diaphragm assessment in predicting extubation failure in patients requiring neurointensive care: a single-center observational study.Scientific reports · 2025Observational
- Weaning Failure in Elderly Patients: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2024Review
- Combined lung and diaphragm ultrasound predicts extubation outcomes in ARDS: a prospective study.European journal of medical research · 2024Article
- Predictive Value of Diaphragm and Lung Ultrasonography for Weaning Failure in Critically Ill Patients with Acute Respiratory Failure Due to COVID-19 Pneumonia.Diagnostics (Basel, Switzerland) · 2024Article
- Diaphragmatic Ultrasonography in Sports Performance: A Systematic Review.Life (Basel, Switzerland) · 2024Review
- Predictive Value of Serial Rapid Shallow Breathing Index Measurements for Extubation Success in Intensive Care Unit Patients.Medicina (Kaunas, Lithuania) · 2024Observational
- Predicting Successful Weaning through Sonographic Measurement of the Rapid Shallow Breathing Index.Journal of clinical medicine · 2024Article
- Ultrasonographic evaluation of diaphragm thickness and excursion: correlation with weaning success in trauma patients: prospective cohort study.Journal of anesthesia · 2024Article
- Combined cardiac, lung, and diaphragm ultrasound for predicting weaning failure during spontaneous breathing trial.Annals of intensive care · 2024Article
- Evaluation of the combined predictive value of multiple indicators based on diaphragmatic ultrasound using logistic regression and ROC curve in weaning from mechanical ventilation in pediatric patients.Frontiers in pediatrics · 2024Article
- Lung Ultrasound Score as a Predictor of Failure to Wean COVID-19 Elderly Patients off Mechanical Ventilation: A Prospective Observational Study.Clinical interventions in aging · 2024Observational
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimum timing to wean is crucial to avoid negative outcomes for mechanically ventilated patients. The rapid shallow breathing index (RSBI), a widely used weaning index, has limitations in predicting weaning outcomes. By replacing the tidal volume of the RSBI with diaphragmatic excursion (DE) and diaphragm thickening fraction (DTF) assessed by ultrasonography, we calculated two weaning indices, the diaphragmatic excursion rapid shallow breathing index (DE-RSBI, respiratory rate [RR]/DE) and the diaphragm thickening fraction rapid shallow breathing index (DTF-RSBI, RR/DTF). The aim of this study was to evaluate the predictive values of DTF-RSBI, DE-RSBI and traditional RSBI in weaning failure.
methodsThis prospective observational study included patients undergoing mechanical ventilation (MV) for > 48 h and who were readied for weaning. During a pressure support ventilation (PSV) spontaneous breathing trial (SBT), right hemidiaphragmatic excursion and DTF were measured by bedside ultrasonography as well as RSBI. Weaning failure was defined as: (1) failing the SBT and (2) SBT success but inability to maintain spontaneous breathing for more than 48 h without noninvasive or invasive ventilation. A receiver operator characteristic (ROC) curve was used for analyzing the diagnostic accuracy of RSBI, DE-RSBI, and DTF-RSBI.
resultsOf the 110 patients studied, 37 patients (33.6%) failed weaning. The area under the ROC (AUROC) curves for RSBI, DE-RSBI, and DTF-RSBI for predicting failed weaning were 0.639, 0.813, and 0.859, respectively. The AUROC curves for DE-RSBI and DTF-RSBI were significantly higher than for RSBI (P = 0.004 and P < 0.001, respectively). The best cut-off values for predicting failed weaning were RSBI > 51.2 breaths/min/L, DE-RSBI > 1.38 breaths/min/mm, and DTF-RSBI > 78.1 breaths/min/%.
conclusionsIn this study, two weaning indices determined by bedside ultrasonography, the DE-RSBI (RR/DE) and DTF-RSBI (RR/DTF), were shown to be more accurate than the traditional RSBI (RR/VT) in predicting weaning outcome during a PSV SBT.
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