Diaphragmatic Kinetics Assessment by Tissue Doppler Imaging and Extubation Outcome.
BACKGROUND: The assessment of diaphragmatic kinetics through tissue Doppler imaging (dTDI) was recently proposed as a means to describe diaphragmatic activity in both healthy individuals and intubated patients undergoing weaning from mechanical ventilation. Our primary aim was to investigate whether...
| Publicado en: | Respiratory Care Vol. 66; no. 6; pp. 983 - 994 |
|---|---|
| Autores principales: | , , , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Jun2021
|
| 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=150953542&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 150953542 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Jun2021 vid: 66 iid: 6 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 150953542 150953542 150953542 10.4187/respcare.08702 150953542 ppf: 983 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Diaphragmatic Kinetics Assessment by Tissue Doppler Imaging and Extubation Outcome. aug: au: Cammarota, Gianmaria Boniolo, Ester Santangelo, Erminio De Vita, Nello Verdina, Federico Crudo, Samuele Sguazzotti, Ilaria Perucca, Raffaella Messina, Antonio Zanoni, Marta Azzolina, Danila Navalesi, Paolo Longhini, Federico Vetrugno, Luigi Bignami, Elena Corte, Francesco della Tarquini, Riccardo De Robertis, Edoardo Vaschetto, Rosanna sug: subj: Diaphragm Physiology Kinetics Echocardiography, Doppler Utilization Extubation Treatment Outcomes Respiration, Artificial Human Continuous Positive Airway Pressure Prospective Studies Nonexperimental Studies Oxygen Saturation Descriptive Statistics Mann-Whitney U Test Fisher's Exact Test ROC Curve Inspiration, Respiratory Middle Age Aged Male Female Respiratory Failure Risk Factors Heart Arrest Risk Factors Comorbidity Respiratory Tract Physiology Ventilator Weaning Middle Aged: 45-64 years Aged: 65+ years Male Female ab: BACKGROUND: The assessment of diaphragmatic kinetics through tissue Doppler imaging (dTDI) was recently proposed as a means to describe diaphragmatic activity in both healthy individuals and intubated patients undergoing weaning from mechanical ventilation. Our primary aim was to investigate whether the diaphragmatic excursion velocity measured with dTDI at the end of a spontaneous breathing trial (SBT) was different in subjects successfully extubated versus those who passed the trial but exhibited extubation failure within 48 h after extubation. METHODS: We enrolled 100 adult subjects, all of whom had successfully passed a 30-min SBT conducted in CPAP of = cm H2O. In cases of extubation failure within 48 h after liberation from invasive mechanical ventilation, subjects were re-intubated or supported through noninvasive ventilation. dTDI was performed at the end of the SBT to assess excursion, velocity, and acceleration. RESULTS: Extubation was successful in 79 subjects, whereas it failed in 21 subjects. The median (interquartile range [IQR]) inspiratory peak excursion velocity (3.1 [IQR 2.0-4.3] vs 1.8 [1.3-2.6] cm/s, P < .001), mean velocity (1.6 [IQR 1.2-2.4] vs 1.1 [IQR 0.8-1.4] cm/s, P < .001), and acceleration (8.8 [IQR 5.0-17.8] vs 4.2 [IQR 2.4-8.0] cm/s², P = .002) were all significantly higher in subjects who failed extubation compared with those who were successfully extubated. Similarly, the median expiratory peak relaxation velocity (2.6 [IQR 1.9-4.5] vs 1.8 [IQR 1.2-2.5] cm/s, P < .001), mean velocity (1.1 [IQR 0.7-1.7] vs 0.9 [IQR 0.6-1.0] cm/s, P = .002), and acceleration (11.2 [IQR 9.1-19.0] vs 7.1 [IQR 4.6-12.0] cm/s², P = .004) were also higher in the subjects who failed extubation. CONCLUSIONS: In our setting, at the end of SBT, subjects who developed extubation failure within 48 h after extubation experienced a greater diaphragmatic activation compared with subjects who were successfully extubated. (ClinicalTrials.gov registration NCT03962322.) pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|