Aim: To evaluate real-time ultrasound in the evaluation of diaphragmatic thickening, thickening fraction and or excursion to predict extubation outcomes. The investigators aimed to compare these parameters with other traditional weaning measures.
The diaphragm is an important respiratory muscle and dysfunction is very common in patients receiving mechanical ventilation. Diaphragm fatigue occurs even in patients who successfully pass the Spontaneous Breathing Test (SBT). Interrupting ventilation too early can lead to increased cardiovascular and respiratory pressure (CO2).retention and hypoxemia with up to 25% of patients requiring reinstitution of ventilator support. Unnecessary delays in liberation from mechanical ventilation also can be deleterious. Complications such as ventilator-associated pneumonia and ventilator-induced diaphragm atrophy can be seen with short periods of mechanical ventilation thereby prolonging mechanical ventilation. As SBT monitoring is insensitive to detect early signs of load-capacity imbalance. The evaluation of the diaphragmatic thickening fraction (DTF) may be also helpful to assess diaphragmatic function and its contribution to respiratory workload. Ultrasound can be used to detect the deflection of the diaphragm, which helps to identify patients with diaphragm dysfunction
Study Type
OBSERVATIONAL
Enrollment
120
ultrasound on diaphragm
Beni-suef
Banī Suwayf, Mequbal, Egypt
diaphragmatic ultrasound thickening
Right diaphragmatic ultrasound measurement thickening in millimeter was made during tidal and deep breathing . patient is in the supine position and measurement of right diaphragm by M-mode and B-mode images
Time frame: during weaning from mechanical ventilation 0n T- tube, through study completion, an average of 1 year
diaphragmatic ultrasound thickening fraction
Right diaphragmatic ultrasound measurement thickening fraction(percentage% ) was made during tidal and deep breathing . patient is in the supine position and measurement of right diaphragm by M-mode and B-mode images
Time frame: during weaning from mechanical ventilation 0n T- tube, through study completion, an average of 1 year
diaphragmatic ultrasound excursion
Right diaphragmatic ultrasound measurement excursion( centimeter) was made during tidal and deep breathing . patient is in the supine position and measurement of right diaphragm by M-mode and B-mode images
Time frame: during weaning from mechanical ventilation 0n T- tube, through study completion, an average of 1 year
diaphragmatic ultrasound thickening fraction
Differences in thickening fraction ( millimeter )between patients who are successfully and failed weaning .
Time frame: Up to 48 hours on T-tube, through study completion, an average of 1 year
diaphragmatic ultrasound thickening
Differences in diaphragm thickening(percentage% )between patients who are successfully and failed weaning .
Time frame: Up to 48 hours on T-tube, through study completion, an average of 1 year
diaphragmatic ultrasound excursion
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Differences in diaphragm excursion ( centimeter) between patients who are successfully and failed weaning
Time frame: Up to 48 hours on T-tube, through study completion, an average of 1 year