Usefulness of diaphragmatic ultrasound in predicting extubation success

Abstract

ObjectiveTo evaluate the diagnostic accuracy of diaphragmatic ultrasound in predicting extubation success. DesignA diagnostic accuracy study was carried out. ScopeIntensive Care Unit of an Academic hospital in the city of Bogotá (Colombia). Patients or participantsA consecutive sample of patients >18 years of age subjected to invasive mechanical ventilation for >48h. InterventionsDiaphragmatic ultrasound evaluation at the end of spontaneous ventilation testing. Main variables of interestDiaphragmatic 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, %). ResultsA 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). ConclusionsDiaphragm contraction speed exhibited acceptable discriminatory capacity. Ultrasound could be part of a multifactorial approach in the extubation process.