The ratio of parasternal intercostal muscle-thickening fraction-to-diaphragm thickening fraction for predicting weaning failure

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care Pub Date : 2024-06-22 DOI:10.1016/j.jcrc.2024.154847

Li Peng , Hongshan Kang , Hairong Chang , Yue Sun , Yuanyuan Zhao , Heling Zhao

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引用次数: 0

Abstract

Background

Diaphragm dysfunction is associated with weaning outcomes in mechanical ventilation patients, in the case of diaphragm dysfunction, the accessory respiratory muscles would be recruited. The main purpose of this study is to explore the performance of parasternal intercostal muscle thickening fraction in relation to diaphragmatic thickening fraction ratio (TFic¹/TFdi²) for predicting weaning outcomes, and compare its accuracy with D-RSBI in predicting weaning failure.

Materials and methods

We prospectively enrolled consecutive patients from 7/2022–5/2023. We measured TFic, TFdi, and diaphragmatic excursion (DE³) by ultrasound and calculated the TFic/TFdi ratio and diaphragmatic rapid shallow breathing index (D-RSBI⁴). Receiver-operator characteristic (ROC⁵) curves evaluated the accuracy of the TFic/TFdi ratio and D-RSBI in predicting weaning failure.

Results

161 were included in the final analysis, 114 patients (70.8%) were successfully weaned from mechanical ventilation. The TFic/TFdi ratio (AUROC = 0.887 (95% CI: 0.821–0.953)) was superior to the D-RSBI (AUROC = 0.875 (95% CI: 0.807–0.944)) for predicting weaning failure.

Conclusions

The TFic/TFdi ratio predicted weaning failure with high accuracy and outperformed the D-RSBI.

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预测断奶失败的胸骨旁肋间肌增厚分数与膈肌增厚分数之比。

背景：膈肌功能障碍与机械通气患者的断气结果有关，在膈肌功能障碍的情况下，辅助呼吸肌将被征用。本研究的主要目的是探讨胸骨旁肋间肌增厚分数与膈肌增厚分数比（TFic1/TFdi2）在预测断气结果方面的性能，并比较其与 D-RSBI 在预测断气失败方面的准确性：我们前瞻性地纳入了 2022 年 7 月至 2023 年 5 月的连续患者。我们通过超声波测量了TFic、TFdi和膈肌偏移（DE3），并计算了TFic/TFdi比值和膈肌快速浅呼吸指数（D-RSBI4）。接收器-操作者特征曲线（ROC5）评估了TFic/TFdi比值和D-RSBI预测断奶失败的准确性：最终分析共纳入 161 例患者，其中 114 例（70.8%）成功从机械通气中断奶。在预测断奶失败方面，TFic/TFdi 比值（AUROC = 0.887 (95% CI: 0.821-0.953)）优于 D-RSBI（AUROC = 0.875 (95% CI: 0.807-0.944)）：结论：TFic/TFdi比值预测断奶失败的准确性很高，优于D-RSBI。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of critical care 医学-危重病医学

CiteScore

8.60

自引率

2.70%

发文量

237

审稿时长

23 days

期刊介绍： The Journal of Critical Care, the official publication of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), is a leading international, peer-reviewed journal providing original research, review articles, tutorials, and invited articles for physicians and allied health professionals involved in treating the critically ill. The Journal aims to improve patient care by furthering understanding of health systems research and its integration into clinical practice. The Journal will include articles which discuss: All aspects of health services research in critical care System based practice in anesthesiology, perioperative and critical care medicine The interface between anesthesiology, critical care medicine and pain Integrating intraoperative management in preparation for postoperative critical care management and recovery Optimizing patient management, i.e., exploring the interface between evidence-based principles or clinical insight into management and care of complex patients The team approach in the OR and ICU System-based research Medical ethics Technology in medicine Seminars discussing current, state of the art, and sometimes controversial topics in anesthesiology, critical care medicine, and professional education Residency Education.