Comparison of clinical utility between diaphragm excursion and thickening change using ultrasonography to predict extubation success.

Content Provider	Europe PMC
Author	Yoo, Jung-Wan Lee, Seung Jun Lee, Jong Deog Kim, Ho Cheol
Copyright Year	2018
Abstract	Background/AimsBoth diaphragmatic excursion and change in muscle thickening are measured using ultrasonography (US) to assess diaphragm function and mechanical ventilation weaning outcomes. However, which parameter can better predict successful extubation remains to be determined. The aim of this study was to compare the clinical utility of these two diaphragmatic parameters to predict extubation success.MethodsThis study included patients subjected to extubation trial in the medical or surgical intensive care unit of a university-affiliated hospital from May 2015 through February 2016. Diaphragm excursion and percent of thickening change (Δtdi%) were measured using US within 24 hours before extubation.ResultsSixty patients were included, and 78.3% (47/60) of these patients were successfully extubated, whereas 21.7% (13/60) were not. The median degree of excursion was greater in patients with extubation success than in those with extubation failure (1.65 cm vs. 0.8 cm, p < 0.001). Patients with extubation success had a greater Δtdi% than those with extubation failure (42.1% vs. 22.5%, p = 0.03). The areas under the receiver operating curve for excursion and Δtdi% were 0.836 (95% confidence interval [CI], 0.717 to 0.919) and 0.698 (95% CI, 0.566 to 0.810), respectively (p = 0.017).ConclusionsDiaphragm excursion seems more accurate than a change in the diaphragm thickness to predict extubation success.
ISSN	12263303
Volume Number	33
PubMed Central reference number	PMC5840594
Issue Number	2
PubMed reference number	29050461
Journal	The Korean Journal of Internal Medicine [Korean J. Intern. Med]
e-ISSN	20056648
DOI	10.3904/kjim.2016.152
Language	English
Publisher	The Korean Association of Internal Medicine
Publisher Date	2017-10-19
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2018 The Korean Association of Internal Medicine
Subject Keyword	Extubation Diaphragm Ultrasonography Excursion Thickness
Content Type	Text
Resource Type	Article
Subject	Internal Medicine