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| Diagnostic value of diaphragmatic rapid shallow breathing index(D-RSBI)and diaphragm thickening fraction(DTF)in weaning from mechanical ventilation |
| Wang Zhi-li, Li Jian-guo, Deng Bin, Li Wan-li, Jiang Fang |
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Abstract Objective To evaluate diagnostic value of diaphragmatic rapid shallow breathing index (D-RSBI)and diaphragm thickening fraction(DTF)in weaning from mechanical ventilation. Methods All patients were ventilated mechanically for more than 48 hours and were expected to be weaned when they met clinical criteria in the intensive care unit from March 2017 to September 2017. During a T-tube spontaneous breathing trial (SBT) we simultaneously evaluated right hemidiaphragm by using M-mode ultrasonography. Diaphragmatic displacement(DD), diaphragm thickness, outcome of the weaning attempt were recorded.Receiver operator characteristic (ROC) curves were used to evaluate the diagnostic accuracy of D-RSBI and DTF. Results We enrolled 48 patients requiring mechanical ventilation for more than 48 h who were ready to perform a SBT. Most of the patients, 29(60.4%), were successfully weaned from mechanical ventilation. When considering the 19 patients that failed the weaning attempt, 3 (6.25%) had to be reconnected to the ventilator during the SBT, 8(16.7%) had to be re-intubated within 48 h of extubation, and 8 (16.7%) required non-invasive ventilation support within 48 h of extubation. The areas under the ROC curves for D-RSBI were 0.848 (P＜0.05). The sensitivity and specificity were 76.9% and 85.2%, respectively. The areas under the ROC curves for DTF were 0.894(P＜0.05). The sensitivity and specificity were 80.2% and 89.7%, respectively. Conclusion DTF is more accurate than D-RSBI in predicting the weaning outcome.
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Corresponding Authors:
Li Jian-guo,E-mail:drljg1817@163.com
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