The Value Of Diaphragmatic Ultrasound Combined With Echocardiography In Predicting Weaning From Mechanical Ventilation In Critically Ill Patients

Objective:To evaluate the value of diaphragmatic ultrasound combined with echocardiography in predicting weaning from mechanical ventilation in critically ill patients.Methods:Fifty six patients who were undergoing mechanical ventilation were enrolled in Intensive Care Unit of the First Hospital of Shanxi Medical University.When meeting the standard of weaning from mechanical ventilation,spontaneous breathing test(SBT)would be conducted.During SBT,diaphragmatic excursion and cardiac function tests were measured by ultrasound in succession.The patients were divided into success group and failure group according to the results of weaning.Binary logistic regression analysis and receiver operator characteristic curves(ROC curves)analysis were used to evaluate the predictive value of valuable parameters.Results:Of the 56 patients,15 patients failed in weaning procedure.A cut-off value of DE less than 12.40 mm was associated with weaning failure with the AUC of 0797,a sensitivity of 88%,a specificity of 67%.The AUC of E/e’ value was 0.787,and a cut-off value ≥11.90 showed the highest diagnostic accuracy with a sensitivity and specificity of 95% and 67% respectively.The AUC of DE combined with E/e’ value was 0.866,with a sensitivity and specificity of 83% and 87% respectively.Conclusion:Monitoring DE and E/e’ during SBT is helpful to identify the risk of weaning failure of cardiovascular origin and diaphragmatic origin respectively.DE and E/e’ can be used as clinical indexes to predict the results of weaning.Weaning failure is prevalent if the patient is afflicted with diaphragmatic dysfunction and(or)diastolic dysfunction.The combination of DE and E/e’ can improve the predictive value.