Sonographic assessment of diaphragm thickness and its effect on weaning outcome and lung mechanics in patients with chronic obstructive pulmonary disease under mechanical ventilation

Abstract

Successful separation from a ventilator depends on several factors: muscular, cardiac, respiratory and metabolic strength. Acquired weakness of the diaphragm muscle following mechanical ventilation is one of the growing causes of failure to separate patients from the ventilator; On the other hand, thickening fraction and diaphragm ultrasound have been shown to be good non-invasive indicators for deciding whether to separate patients from the ventilator. Materials and Methods: In this study, patients with chronic obstructive pulmonary disease were selected under mechanical ventilation and admitted to intensive care units for one year. Sixty patients were evaluated during the statistical consultation. There was no gender difference in the number of patients. After selecting the patients, all patients underwent B mode ultrasound with a linear probe of nine to twelve MHz on the second day after intubation in supine position. In all patients, the diaphragm thickness was measured at the end of exhalation and in the intercostal space between nine and ten between the anterior and middle axillary line, and the results were compared between individuals with successful and unsuccessful Winning methods. Results: Difference in diaphragm thickness fraction between successful and unsuccessful Winning groups with a median of 32.65% and an inter-quarter range of 24.50% to 34.25% in a successful and middle Winning group of 17.50% and an inter-quarter range of 13% to 25% Shows unsuccessful in the Winning group. Also, based on the results, it was found that the duration of ventilation (P = 0.001), current volume (P = 0.049), Cdyn (P = 0.005), Cstat (P = 0.019) and APACHE II ( P = 0.009) in patients with successful winning were significantly better and better.