Background Sonographic evaluation of the diaphragm has gained popularity in the ICU due to the necessity
of assessing diaphragmatic function in a variety of clinical situations. The sonographic examination of diaphragmatic
dynamics in ICU patients by measuring diaphragmatic thickness and excursion in connection to various modalities
of mechanical ventilation (MV) and patient outcomes was the objective of this study.
Methods This prospective observational study was carried out on 50 patients in respiratory ICU in Kafr Elsheikh
and Benha University Hospitals. Patients were classified into 2 equal groups: COVID-19 group and non-COVID group.
All patients underwent ultrasound assessment included the diaphragm thickness fraction and excursion in ICU
patients on admission and on weaning.
Results Successful weaning (SW) was higher in group I compared to group II. In group I (COVID), diaphragm excursion,
thickness at end inspiration and at end expiration in NIV at weaning were significantly higher in patients with SW
but thickness at end expiration on admission was significantly lower. In group II (non-COVID) MV patients, excursion
at weaning was significantly higher in patients with SW, also were thickness at end inspiration and end expiration
on admission, thickness at end inspiration and end expiration at weaning in NIV patients but thickness at end inspiration
in MV on admission was significantly lower.
Conclusion Weaning success and mortality were significantly predicted by excursion in NIV at weaning, thickness
at end inspiration in MV at weaning, thickness at end inspiration in NIV at weaning, and thickness at end expiration
in MV at weaning. |
