Evidence map›Paper›PMID 39757317›Full record

Observational studyJournal of anesthesia2025

The ability of diaphragmatic excursion after extubation to predict the need for resumption of ventilatory support in critically ill surgical patients.

Ahmed Hasanin, Mina A Helmy, Ayman Aziz, Maha Mostafa, Mostafa Alrahmany, Mamdouh M Elshal, Walid Hamimy, Ahmed Lotfy

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of anesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Ahmed HasaninDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt. ahmedmohamedhasanin@gmail.com.ORCID http://orcid.org/0000-0001-9947-5863
Mina A HelmyDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Ayman AzizDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Maha MostafaDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Mostafa AlrahmanyDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Mamdouh M ElshalDepartment of Anesthesia and Critical Care Medicine, National Cancer Institute, Cairo University, Cairo, Egypt.
Walid HamimyDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.
Ahmed LotfyDepartment of Anesthesia and Critical Care Medicine, Cairo University, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study evaluated the ability of diaphragmatic excursion (DE), measured 2 h after extubation, to predict the need for resumption of ventilatory support within 48 h in surgical critically ill patients.

methodsThis prospective observational study included adult surgical critically ill patients intubated for > 24 h and extubated after a successful spontaneous breathing trial. Sonographic measurement of the DE was performed 2 h after extubation. Patients were followed up for 48 h after extubation and were divided into reintubation group and successful weaning group. The primary outcome was DE's ability to predict the need for resumption of ventilatory support using the area under receiver characteristic curve (AUC) analysis.

resultsData from 70 patients were analyzed and 25/70 (36%) patients needed reintubation. DE was lower in the reintubation group than the successful weaning group. The AUC (95% confidence interval) for the ability of DE to predict the need for resumption of ventilatory support was 0.98(0.92-1.00) and 0.97(0.89-1.00) for the right and left side, respectively. At cutoff values of 20.8 and 19.8 mm, the right and left DE had positive predictive values of 92% and 88% and negative predictive values of 96% and 93%, respectively.

conclusionAmong surgical critically ill patients undergoing weaning from invasive mechanical ventilation, DE obtained 2h after extubation is an accurate predictor for the need for resumption of ventilatory support. Diaphragmatic excursion < 20-21 mm could predict the need for resumption of ventilatory support with a positive predictive value of 88-92% and negative predictive value of 93-96%.

Indexed as

Airway ExtubationCritical IllnessDiaphragmRespiration, ArtificialVentilator WeaningAdultAgedFemaleHumansMaleMiddle AgedPredictive Value of TestsProspective StudiesUltrasonographyCritically illDiaphragmatic excursionMechanical ventilationReintubationUltrasoundWeaning

Identifiers

PMID39757317
PMCPMC11937106

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Registered trials

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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.