Huda Fahmy, Mohamed Saied, Islam Sayed and Sayed Kinawy
Background: A primary priority for all intensivists is identifying strategies to reduce the duration of Mechanical Ventilation (MV) and deciding the ideal time for extubation.
Aim: To evaluate the role of the diaphragm and lung ultrasonography principally (DE, DTF, and LUS scores) in the prediction of extubation outcomes from MV.
Patients and methods: This prospective observational study included sixty-eight adult patients who required invasive MV for as a minimum of 24 hours and successfully passed a spontaneous breathing trial (SBT) were enrolled in our study. At the end of a successful SBT, we assessed by ultrasound DE, DTF and lung parenchyma.
Results: 53 patients (78%) successfully extubated while, 15 patients (22%) experienced failed extubation. DTF% with cutoff value ≥ 30% had the highest sensitivity (100%), negative predictive value (100%) and the highest accuracy (89.24%). On combining DTF% ≥ 30% and LUS ≤ 12, specificity and the diagnostic accuracy raised to (100% and 96% respectively) with highly precise AUC (0.97).
Conclusion: The integration of DTF % ≥ 30% of the right hemi-diaphragm with LUS ≤ 12 improved the expectation of successful extubation in comparison with DTF % alone.