Evidence map›Paper›PMID 38507058›Full record

ArticleJournal of anesthesia2024

Ultrasonographic evaluation of diaphragm thickness and excursion: correlation with weaning success in trauma patients: prospective cohort study.

Golnar Sabetian, Mandana Mackie, Naeimehossadat Asmarian, Mahsa Banifatemi, Gregory A Schmidt, Mansoor Masjedi, Shahram Paydar, Farid Zand

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Article in Journal of anesthesia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2 citing papers in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Golnar SabetianAnesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Mandana MackieAnesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Naeimehossadat AsmarianAnesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Mahsa BanifatemiAnesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Gregory A SchmidtUniversity of Iowa, Iowa City, IA, USA.
Mansoor MasjediAnesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Shahram PaydarTrauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Farid ZandAnesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. zandf@sums.ac.ir.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeProlonged mechanical ventilation (MV) subjects multiple trauma patients to ventilator-induced diaphragmatic dysfunction. There is limited evidence on the predictive role of diaphragm ultrasound (DUS) for weaning success in multiple trauma patients. Therefore, we evaluated Ultrasound of the diaphragm as a valuable indicator of weaning outcomes, in trauma patients. MATERIAL AND

methodsThis prospective cohort study included 50 trauma patients from September 2018 to February 2019. DUS was performed twice: upon ICU admission and the first weaning attempt. The diagnostic accuracy of indexes was evaluated by ROC curves.

resultsThe study included patients with a mean age of 35.4 ± 17.37, and 78% being male. The median injury severity score was 75 (42-75). The failure group exhibited significantly lower right diaphragmatic excursion (DE) compared to the success group (P = 0.006). In addition, the failure group experienced a significant decrease in both right and left DE from admission to the first attempt of weaning from MV (P < 0.001). Both groups showed a significant decrease in inspiratory and expiratory thickness on both sides during weaning from MV compared to the admission time (P < 0.001). The findings from the ROC analysis indicated that the Rapid shallow breathing index (RSBI) (Sensitivity = 91.67, Specificity = 100), respiratory rate (RR)/DE (Right: Sensitivity = 87.5, Specificity = 92.31), and RR/TF (Thickening Fraction) (Right: Sensitivity = 83.33, Specificity = 80.77) demonstrated high sensitivity and specificity in predicting weaning outcome.

conclusionIn the context of patients with multiple trauma, employing DUC and assessing diaphragmatic excursion, thickness, RR/DE index, RR/TF index, and RSBI can aid in determining successful ventilator weaning.

Indexed as

DiaphragmUltrasonographyVentilator WeaningAdultCohort StudiesFemaleHumansMaleMiddle AgedMultiple TraumaProspective StudiesRespiration, ArtificialYoung AdultDiaphragmMechanical ventilationTraumaUltrasoundVentilator weaning

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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.