Predictive values of ultrasonic diaphragm thickening fraction combined with integrative weaning index in weaning patients with mechanical ventilation: a retrospective study

Abstract

Abstract Objective We aimed to explore the predictive values of ultrasonic diaphragm thickening fraction (DTF) combined with integrative weaning index (IWI) in weaning patients with mechanical ventilation. Methods Patients with mechanical ventilation who received oral endotracheal intubation from September 2020 to September 2021 were included in this retrospective study. Before the start of the spontaneous breathing test (SBT), IWI was calculated according to the blood gas analysis parameters and parameters read in volume control mode. After the start of SBT, DTF was calculated according to the end-expiratory thickness and end-inspiratory thickness of the right diaphragm. The receiver operating curve (ROC) was used to evaluate the predictive value of DTF and IWI for successful weaning, and the sensitivity and specificity were calculated according to the best critical value. Results The sensitivity, specificity, and best cutoff value of DTF to predict successful weaning was 0.772, 0.727, and 0.293, respectively, and the area under the curve (AUC) was 0.72 (95%CI 0.59–0.86, p = 0.003). The sensitivity, specificity, and best cutoff value of IWI to predict successful weaning was 0.614, 0.909, 53.00, respectively, and AUC was 0.82 (95%CI 0.72–0.91, p < 0.001). The sensitivity, specificity, and best cutoff value of the combination of DTF and IWI to predict successful weaning was 0.614, 0.909, 17.848, respectively, and AUC was 0.84 (95%CI 0.75–0.93, p < 0.001). Conclusion DTF and IWI can guide the selection of weaning, while DTF combined with IWI can improve the effect of weaning prediction and provide support for patients’ weaning safety.

Keywords

• Diaphragm thickening fraction
• Integrative weaning index
• Mechanical ventilation
• Weaning
• Ultrasound