Ultrasonographic diaphragmatic excursion is inaccurate and not better than the MRC score for predicting weaning-failure in mechanically ventilated patients
Ultrasonographic diaphragmatic excursion is inaccurate and not better than the MRC score for predicting weaning-failure in mechanically ventilated patients
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DOI：
10.1016/j.accpm.2016.05.009
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发表时间：
2017-02-01
影响因子：
5.5
通讯作者：
Hilbert, Gilles
中科院分区：
文献类型：
--
作者：
Carrie, Cedric;Gisbert-Mora, Chloe;Hilbert, Gilles
目的：评价超声对首次自主呼吸试验(SBT)患者撤机失败的预测能力。方法：67例首次自主呼吸试验(SBT)患者在4个月的时间里，采用右前肋下入路超声测量最大横隔肌偏移(MDE)。撤机失败定义为SBT失败或因急性呼吸衰竭需要恢复机械支持或在成功拔管后48h内死亡。通过受试者操作曲线分析评估隔膜超声和医学研究委员会(MRC)评分预测脱机失败的准确性。结果：超声测量的可行性为63%。首次脱机成功的患者的MDE平均值显著高于脱机成功的患者(4.1+/-2.1和3+/-1.8 cm，P=0.04)。使用MDE的阈值
Purpose: To assess the ability of diaphragmatic ultrasound (US) to predict weaning failure in mechanically ventilated patients undergoing a first spontaneous breathing trial (SBT).Methods: During a 4-month period, 67 consecutive patients eligible for a first SBT underwent US measurements of maximal diaphragmatic excursion (MDE) by a right anterior subcostal approach. Weaning failure was defined as either the failure of SBT or the need for resumption of ventilatory support for acute respiratory failure or death within 48 h following successful extubation. The accuracy of diaphragmatic ultrasound and the Medical Research Council (MRC) score when predicting weaning failure was assessed via a receiver operating curve analysis.Results: The feasibility rate for the ultrasound measurements was 63%. Mean values of MDE were significantly higher in patients who succeeded at their first weaning attempt (4.1 +/- 2.1 versus 3 +/- 1.8 cm, P = 0.04). Using a threshold of MDE