Usefulness of diaphragmatic ultrasound in predicting extubation success

Abstract

To evaluate the diagnostic accuracy of diaphragmatic ultrasound in predicting extubation success. A diagnostic accuracy study was carried out. Intensive Care Unit of an Academic hospital in the city of Bogotá (Colombia). A consecutive sample of patients >18 years of age subjected to invasive mechanical ventilation for >48h. Diaphragmatic ultrasound evaluation at the end of spontaneous ventilation testing. Diaphragmatic excursion (DE, cm), inspiration time (TPIAdia, s), diaphragm contraction speed (DE/TPIAdia, cm/s) and total time (Ttot, s) were evaluated, together with thickening fraction (TFdi, %). A total of 84 patients were included, 79.8% (n=67) with successful extubation and 20.2% (n=17) with failed extubation. The variable with the best discriminatory capacity in predicting extubation success was diaphragm contraction speed, with AUC-ROC 0.70 (p=0.008). Diaphragm contraction speed exhibited acceptable discriminatory capacity. Ultrasound could be part of a multifactorial approach in the extubation process.