ArticleFrontiers in medicine2026
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.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: In neurosurgical intensive care units (ICUs), conventional spontaneous breathing trial (SBT) criteria may not adequately reflect diaphragm function, which can contribute to premature or delayed extubation. Diaphragm ultrasound provides objective bedside measures to support individualized weaning. Methods: This multicenter prospective cohort study enrolled 188 patients from six tertiary hospitals. Patients were sequentially managed in three phases: control (conventional SBT), diaphragm thickening fraction (DTF)-guided management (extended SBT if DTF was below the prespecified threshold), and combined DTF plus diaphragmatic excursion (DE)-guided management. Primary outcomes included first SBT success, first extubation success, reintubation, and duration of mechanical ventilation. Receiver operating characteristic (ROC) and Cohen's kappa analyses were used to evaluate predictive accuracy and agreement between SBT results and extubation outcomes. Results: No significant differences were observed in first SBT success or first extubation success ( Conclusion: Nurse-performed diaphragm ultrasound can be implemented to support physician-led weaning assessment. DTF-based stratification was associated with reduced reintubation and shorter ventilation duration.
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