KSCCM
Search
- Page Path
- HOME > Search
Original Article
- Pulmonary
- The role of diaphragmatic thickness measurement in weaning prediction and its comparison with rapid shallow breathing index: a single-center experience
- Lokesh Kumar Lalwani, Manjunath B Govindagoudar, Pawan Kumar Singh, Mukesh Sharma, Dhruva Chaudhry
- Acute Crit Care. 2022;37(3):347-354. Published online July 25, 2022
- DOI: https://doi.org/10.4266/acc.2022.00108
- 10,494 View
- 320 Download
- 10 Web of Science
- 13 Crossref
-
Abstract
PDF
Supplementary Material - Background
Acute respiratory failure (ARF) is commonly managed with invasive mechanical ventilation (IMV). The majority of the time that a patient spends on IMV is in the process of weaning. Prediction of the weaning outcome is of paramount importance, as untimely/delayed extubation is associated with a high risk of mortality. Diaphragmatic ultrasonography is a promising tool in the intensive care unit, and its utility in predicting the success of weaning remains understudied.
Methods
In this prospective-observational study, we recruited 54 ARF patients on IMV, along with 50 healthy controls. During a spontaneous breathing trial, all subjects underwent diaphragmatic ultrasonography along with a rapid shallow breathing index (RSBI) assessment.
Results
The mean age was 41.8±17.0 and 37.6±10.5 years among the cases and control group, respectively. Demographic variables were broadly similar in the two groups. The most common cause of ARF was obstructive airway disease. The average duration of IMV was 5.41±2.81 days. Out of 54 subjects, 45 were successfully weaned, while nine patients failed weaning. Age, body mass index, and severity of disease were similar in the successful and failed weaning patients. The sensitivity in predicting successful weaning of percent change in diaphragmatic thickness (Δtdi%) >29.71% was high (93.33%), while specificity was 66.67%. The sensitivity and specificity of mean diaphragmatic thickness (tdi) end-expiratory >0.178 cm was 60.00% and 77.78%, respectively. RSBI at 1 minute of <93.75 had an equally high sensitivity (93.33%) but a lower specificity (22.22%). Similar results were also found for RSBI measured at 5 minutes.
Conclusions
During the weaning assessment, the purpose is to minimize both premature as well as delayed extubation. We found that diaphragmatic ultrasonography, in particular Δtdi%, is better than RSBI in predicting weaning outcomes. -
Citations
Citations to this article as recorded by
- Predictive accuracy of lung and diaphragmatic ultrasound in weaning from mechanical ventilation: a comparison with the Rapid Shallow Breathing Index
Shalini Bellan, Komaldeep Kaur, Surabhi Jaggi, Mandeep Kaur Sodhi, Deepak Aggarwal, Varinder Saini, Narinder Kaur, Manpreet Singh
Monaldi Archives for Chest Disease.2026;[Epub] CrossRef - The effectiveness of the AI-based RehabLung mobile rehabilitation system on cardiopulmonary function and user satisfaction in lung cancer patients undergoing thoracic surgery: a protocol for a two-arm randomized clinical trial
Hsin-Lun Yang, Ching-Hsia Hung, Yu-Ting Huang, Hui-Ching Cheng, Yau-Lin Tseng, Jun-Ming Su, Kun-Ling Tsai
Therapeutic Advances in Respiratory Disease.2026;[Epub] CrossRef - Effects of diaphragmatic facilitation methods on respiratory muscle strength in patients with chronic stroke: A randomized controlled trial
Sanjivani Kamble, Yukta Churi, Rajesh Kuber
Journal of Clinical Sciences.2026; 23(2): 77. CrossRef - Évaluation de la dysfonction du diaphragme
M. Daniel, C. Delplancke, P. Desforges, K. Guessous, J. Castillo, T. Groseil, B. Cholley
EMC - Pneumologie.2026; 37(3): 1. CrossRef - Point-of-Care Ultrasound, an Integral Role in the Future of Enhanced Recovery After Surgery?
Peter Van de Putte, An Wallyn, Rosemary Hogg, Lars Knudsen, Kariem El-Boghdadly
Anesthesia & Analgesia.2025; 140(5): 1114. CrossRef - A Muscle-Driven Spine Model for Predictive Simulations in the Design of Spinal Implants and Lumbar Orthoses
Robin Remus, Andreas Lipphaus, Marisa Ritter, Marc Neumann, Beate Bender
Bioengineering.2025; 12(3): 263. CrossRef - Diaphragm Ultrasound for Assessing Diaphragmatic Function and Predicting Ventilator Weaning Success: A Review of the Literature
Gulus Emre, Daniel Acosta, Cameron Baston
Current Pulmonology Reports.2025;[Epub] CrossRef - Ultrasonography to Access Diaphragm Dysfunction and Predict the Success of Mechanical Ventilation Weaning in Critical Care
Marta Rafael Marques, José Manuel Pereira, José Artur Paiva, Gonzalo García de Casasola‐Sánchez, Yale Tung‐Chen
Journal of Ultrasound in Medicine.2024; 43(2): 223. CrossRef - Accuracy of respiratory muscle assessments to predict weaning outcomes: a systematic review and comparative meta-analysis
Diego Poddighe, Marine Van Hollebeke, Yasir Qaiser Choudhary, Débora Ribeiro Campos, Michele R. Schaeffer, Jan Y. Verbakel, Greet Hermans, Rik Gosselink, Daniel Langer
Critical Care.2024;[Epub] CrossRef - Ultrasonographic evaluation of diaphragm thickness and excursion: correlation with weaning success in trauma patients: prospective cohort study
Golnar Sabetian, Mandana Mackie, Naeimehossadat Asmarian, Mahsa Banifatemi, Gregory A. Schmidt, Mansoor Masjedi, Shahram Paydar, Farid Zand
Journal of Anesthesia.2024; 38(3): 354. CrossRef - Diaphragm muscle parameters as a predictive tool for weaning critically ill patients from mechanical ventilation: a systematic review and meta-analysis study
Yashar Iran Pour, Afrooz Zandifar
European Journal of Translational Myology.2024;[Epub] CrossRef - Diaphragm dysfunction as a prognostic criterion of external respiratory impairment and necessary extracorporeal membrane oxygenation in patients with chronic heart failure
V.S. Shabaev, V.A. Mazurok, L.Z. Biktasheva, L.G. Vasilyeva, K.Yu. Kozhieva, I.A. Danilova, N.A. Osipova
Russian Journal of Anesthesiology and Reanimatology.2024; (6): 38. CrossRef - Diaphragmatic ultrasound: A new frontier in weaning from mechanical ventilation
Manoj Kamal, Saikat Sengupta
Indian Journal of Anaesthesia.2023; 67(Suppl 4): S205. CrossRef
- Predictive accuracy of lung and diaphragmatic ultrasound in weaning from mechanical ventilation: a comparison with the Rapid Shallow Breathing Index
First
Prev
