Diaphragmatic Dysfunction Is Characterized by Increased Duration of Mechanical Ventilation in Subjects With Prolonged Weaning.
BACKGROUND: Diaphragmatic dysfunction is often underdiagnosed and is among the risk factors for failed weaning. The purpose of this study was to determine the prevalence of diaphragmatic dysfunction diagnosed by B-niode ultrasonography and to determine whether prolonged weaning subjects with diaphra...
| Publicado en: | Respiratory Care Vol. 61; no. 10; pp. 1316 - 1323 |
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| Autores principales: | , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Oct2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=118570225&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 118570225 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Oct2016 vid: 61 iid: 10 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 118570225 118570225 118570225 10.4187/respcare.04746 118570225 ppf: 1316 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Diaphragmatic Dysfunction Is Characterized by Increased Duration of Mechanical Ventilation in Subjects With Prolonged Weaning. aug: au: Zhihua Lu Qiuping Xu Yuehua Yuan Ge Zhang Feng Guo Huiqing Ge affil: Department of Critical Care Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China sug: subj: Respiration, Artificial Ventilator Weaning Diaphragm Physiopathology Time Factors Human Prevalence Diaphragm Ultrasonography Prospective Studies Nonexperimental Studies Respiration Descriptive Statistics Male Female Middle Age Aged Interrater Reliability Intrarater Reliability Adolescence Adult China Academic Medical Centers Positive End-Expiratory Pressure P-Value APACHE (Acute Physiology and Chronic Health Evaluation) Clinical Assessment Tools Ultrasonography Methods Repeated Measures Data Analysis Software Unpaired T-Tests Chi Square Test Middle Aged: 45-64 years Aged: 65+ years Adolescent: 13-18 years Adult: 19-44 years Male Female ab: BACKGROUND: Diaphragmatic dysfunction is often underdiagnosed and is among the risk factors for failed weaning. The purpose of this study was to determine the prevalence of diaphragmatic dysfunction diagnosed by B-niode ultrasonography and to determine whether prolonged weaning subjects with diaphragmatic dysfunction have increased duration of mechanical ventilation compared with those without diaphragmatic dysfunction. METHODS: This was a prospective observational study in mechanically ventilated subjects who failed >3 spontaneous breathing trials or required >7 d of weaning after the first spontaneous breathing trial. Diaphragm thickness was measured in the zone of apposition using a 6-13-MHz ultrasound transducer during a spontaneous breathing trial. The diaphragmatic thickening fraction was calculated as a percentage from the formula: (Thickness at peak inspiration -- thickness at end expiration)/thickness at end expiration. Intra-observer and inter-observer reliability were also evaluated. RESULTS: Forty-one subjects (24 males; 62.2 ± 15.9 y old) were included in the study. Of these, the prevalence of ultrasonographic diaphragmatic dysfunction (defined as diaphragmatic thickening fraction of <20% with inspiration) was 34.1% (« = 14). Subjects with diaphragmatic dysfunction had longer ventilation time after inclusion (293.4 ± 194.8 vs 145.1 ± 101.3 h, P = .02) and ICU stay (29.2 ± 11.4 vs 22.4 ± 7.7 d, P = .03) than subjects without diaphragmatic dysfunction. CONCLUSIONS: Diaphragmatic dysfunction as assessed by B-mode ultrasonography is common in subjects with prolonged weaning. Subjects with such diaphragmatic dysfunction show longer mechanical ventilation durations and ICU stays. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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