ArticleBMC pulmonary medicine2023
The ratio of respiratory rate to diaphragm thickening fraction for predicting extubation success.
Article in BMC pulmonary medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled 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
- Diaphragm ultrasound monitoring and sequential muscle training for weaning elderly COPD patients from mechanical ventilation.Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Trial
- Comparison of standardized diaphragm ultrasound measurement and conventional methods for predicting weaning failure: a prospective observational study.Journal of anesthesia · 2026Observational
- 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
- Article
- Diaphragmatic ultrasound-derived MV×DE: a novel predictor of postextubation adverse respiratory events in general anesthesia patients (observational study).BMC pulmonary medicine · 2025Observational
- Role of ventilator and ultrasound parameters in predicting extubation success.Scientific reports · 2025Article
- Predictors of weaning failure in ventilated intensive care patients: a systematic evidence map.Critical care (London, England) · 2024Review
- Ultrasonographic evaluation of diaphragm thickness and excursion: correlation with weaning success in trauma patients: prospective cohort study.Journal of anesthesia · 2024Article
- Point-of-Care Ultrasound Evaluation of Diaphragm as a Predictor of Extubation Success in Mechanically Ventilated, Malnourished, End-Stage Liver Disease Pretransplant Candidates-Observational Cohort Study.Therapeutic advances in pulmonary and critical care medicineArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral parameters are used to predict successful extubation but their accuracy varies among studies. We hypothesized that combining conventional and diaphragmatic parameters would be more effective than using just one. Our primary objective was to evaluate the performance of the respiratory rate in relation to the diaphragm thickening fraction (RR/DTF) ratio to predict the success of extubation.
methodsWe enrolled 130 adult patients who required invasive mechanical ventilation, planned to be extubated, and used a spontaneous breathing trial (SBT) in the intensive care unit from July 2020 to April 2022. We measured the conventional parameters and the diaphragmatic parameters 2 h after SBT. The RR/DTF was calculated by dividing the respiratory rate (RR) by the diaphragm thickening fraction (DTF). The definition of weaning success is successful extubation within 48 h.
resultsOf 130 patients, 8 patients (6.2%) were reintubated within 48 h. The RR/DTF was significantly lower in the successful extubation group than in the extubation failure group (right hemidiaphragm; 0.47 (0.33-0.64) vs 1.1 (0.6-2.32), p < 0.001 and left hemidiaphragm; 0.45 (0.31-0.65) vs 0.78 (0.48-1.75), p < 0.001). The right RR/DTF using a cut-off point at ≤ 0.81 had a sensitivity of 87.7%, a specificity of 75%, and areas under the receiver operating characteristic curve (AUROC) of 0.762 for predicting successful extubation (p = 0.013). The sensitivity, specificity, and AUROC for predicting extubation success of right DTF at a cut-off point of ≥ 26.2% were 84.3%, 62.5%, and 0.775, respectively (p = 0.009).
conclusionThe RR/DTF ratio is a promising tool for predicting extubation outcome. Additionally, using RR/DTF was more reliable than conventional or diaphragmatic parameters alone in predicting extubation success.
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