Diaphragmatic ultrasound as a predictor of successful extubation from mechanical ventilation in elderly patients

Abstract

lthough mechanical ventilation (MV) is life-saving in a patient with acute respiratory distress which is more prevalent in the elderly age group, it is also one of the most important causes of diaphragmatic dysfunction and thus MV weaning failure. Diaphragmatic function assessment has a crucial role in the assessment of the weaning outcome. Bedside diaphragmatic ultrasound (US) has an important role in the assessment of diaphragmatic thickness and function with recently used multifunction indices such as diaphragmatic excursion and velocity. Bedside diaphragmatic ultrasonographic examination was performed on 60 patients Aged ≥ 70 years old, who were intubated, mechanically ventilated in ICU. The percentage of patients with Diaphragmatic dysfunction (DD) compared to non-diaphragmatic dysfunction (non-DD) was 3:1. The percentage of weaning success was higher in the non-DD group than the DD group (76.9% and 28.9% respectively).

Diaphragmatic function indices had statistical significance in differentiating both DD and non-DD groups. The cutoff value for diaphragmatic thickness, excursion and velocity was about (1mm&1mm, 13mm&12mm and 16&15mm/s) with area under the curve (0.891&0.77