背景:机械通气患者的膈肌功能障碍与撤机结果相关,在膈肌功能障碍的情况下,副呼吸肌将被招募。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)的关系,以预测断奶结局。并与D-RSBI预测断奶失败的准确性进行比较。
方法:我们前瞻性招募了2022年7月5日/2023年的连续患者。我们测量了TFIC,TFdi,通过超声和diaphragm肌偏移(DE3),并计算TFic/TFdi比率和diaphragm肌快速浅呼吸指数(D-RSBI4)。接收器-操作员特征(ROC5)曲线评估了TFic/TFdi比率和D-RSBI预测断奶失败的准确性。
结果:161个被纳入最终分析,114例患者(70.8%)成功脱离机械通气。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))预测断奶失败。
结论:TFic/TFdi比率可高精度预测断奶失败,优于D-RSBI。
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.
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.