Diaphragmatic Excursion: Does it Predict Successful Weaning from Mechanical Ventilation?.

Arshad Hayat; Aslam Khan; Amir Khalil; Asma Asghar

Author(s)

Arshad Hayat Department of Critical Care Medicine, Military Hospital, Rawalpindi, Pakistan

Aslam Khan Department of Medicine, Military Hospital, Rawalpindi, Pakistan

Amir Khalil Department of Medicine, Military Hospital, Rawalpindi, Pakistan

Asma Asghar Department of Respiratory Medicine, Barnsley Hospital, Barnsley, England

Abstract

Objective: To measure the diaphragmatic excursion and its outcome on weaning from mechanical ventilation. Study Design: Cross-sectional comparative study. Place and Duration of Study: Medical Intensive Care Unit (ICU), Military Hospital (MH), Rawalpindi, Pakistan, from January to December 2014. Methodology: Diaphragmatic excursion (DE) in cm was measured through ultrasound by marking liver and spleen displacement in patients who fulfilled the criteria of removal from ventilatory support. The patients were followed up for 48 hours and classified according to the outcome as successful weaning and weaning failure. Results: Out of 100 cases, 76 patients had a successful weaning while 24 had a failed weaning outcome. At a diaphragmatic excursion of 1.2 cm and more, out of 67 cases, 60 had a successful weaning (89.55%) while 7 cases (10.45%) had a weaning failure. At an excursion of less than 1.2 cm, 17 out of 33 cases (51.5%) had successful weaning while 16 (48.48%) had weaning failure. At this cut off point (1.2 cm), the sensitivity and specificity for successful weaning were 78.95% and 70.83%, respectively. The positive and negative likelihood ratio (LR) for these values being 2.70 and 0.29, respectively. The positive predictive value was 82.35% and negative predictive value 60.00%. Conclusion: Ultrasonographic measurement of diaphragmatic excursion is a good method for predicting weaning outcome from mechanical ventilation.

Publication Details

Page(s) 743-746

DOI DOI not available

Published Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 27, Issue: 12, Year: 2017

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Keywords

Mechanical ventilation. Weaning. Diaphragmatic excursion. Ultrasound.

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