Value of diaphragmatic ultrasound parameters in assessing weaning outcomes and survival in ventilator-dependent intensive care unit patients.

Abstract

Objective: To retrospectively evaluate the utility of diaphragmatic ultrasound parameters in assessing ventilator weaning outcomes and survival in ventilator-dependent intensive care unit (ICU) patients.

Methods: A total of 105 ventilator-dependent ICU patients admitted to our hospital between October 2019 and February 2024 were included in this study. Depending on weaning outcomes, patients were divided into a successful group (n = 86) and a failure group (n = 19). Diaphragmatic ultrasound parameters, including diaphragm excursion (DE), diaphragmatic thickness at the end of expiration (DTee), diaphragmatic thickness at the end of inspiration (DTei), and diaphragmatic thickening fraction (DTF), were collected. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of these parameters for weaning success. Survival curves were analyzed to explore their relationships with survival. Logistic regression analysis was used to identify risk factors influencing survival in ventilator-dependent ICU patients.

Results: Diaphragmatic ultrasound parameters were statistically higher in the successful group compared to the failure group. TFor ventilator-dependent ICU patients, the areas under the curve (AUCs) of DE, DTee, DTei, and DTF in predicting weaning outcomes were 0.757, 0.765, 0.770, and 0.677, respectively. However, when these four indicators were combined for prediction, the AUC could be elevated to 0.938. Logistic regression analysis identified that gender, age, body mass index, disease type, comorbidities, as well as DE, DTee, DTei, and DTF, were not risk factors influencing the survival of these ventilator-dependent ICU patients.

Conclusions: Diaphragmatic ultrasound parameters are valuable tools for assessing the weaning outcomes and survival of ventilator-dependent ICU patients. These parameters provide auxiliary guidance for clinical decision-making and subsequent patient management.