Lung Ultrasound Score as a Predictor of Failure to Wean COVID-19 Elderly Patients off Mechanical Ventilation: A Prospective Observational Study
Ying Wang,1,* Yu Yi,1,* Fan Zhang,1 Yuan-Yuan Yao,2 Yue-Xiu Chen,2 Chao-Min Wu,2 Rui-Yu Wang,2 Min Yan1,2 1Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, People’s Republic of China; 2Department of Anesthesiology, the Second Affiliated Ho...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2024-02-01
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| Series: | Clinical Interventions in Aging |
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| Online Access: | https://www.dovepress.com/lung-ultrasound-score-as-a-predictor-of-failure-to-wean-covid-19-elder-peer-reviewed-fulltext-article-CIA |
| _version_ | 1827346381037109248 |
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| author | Wang Y Yi Y Zhang F Yao YY Chen YX Wu CM Wang RY Yan M |
| author_facet | Wang Y Yi Y Zhang F Yao YY Chen YX Wu CM Wang RY Yan M |
| author_sort | Wang Y |
| collection | DOAJ |
| description | Ying Wang,1,* Yu Yi,1,* Fan Zhang,1 Yuan-Yuan Yao,2 Yue-Xiu Chen,2 Chao-Min Wu,2 Rui-Yu Wang,2 Min Yan1,2 1Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, People’s Republic of China; 2Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310016, People’s Republic of China*These authors contributed equally to this workCorrespondence: Min Yan, Email zryanmin@zju.edu.cnBackground: The lung ultrasound score was developed for rapidly assessing the extent of lung ventilation, and it can predict failure to wean various types of patients off mechanical ventilation. Whether it is also effective for COVID-19 patients is unclear.Methods: This single-center, prospective, observational study was conducted to assess the ability of the 12-region lung ultrasound score to predict failure to wean COVID-19 patients off ventilation. In parallel, we assessed whether right hemidiaphragmatic excursion or previously published predictors of weaning failure can apply to these patients. Predictive ability was assessed in terms of the area under the receiver operating characteristic curve (AUC).Results: The mean age of the 35 patients in the study was (75 ± 9) years and 12 patients (37%) could not be weaned off mechanical ventilation. The lung ultrasound score predicted these failures with an AUC of 0.885 (95% CI 0.770– 0.999, p < 0.001), and a threshold score of 10 provided specificity of 72.7% and sensitivity of 92.3%. AUCs were lower for previously published predictors of weaning failure, and right hemidiaphragmatic excursion did not differ significantly between the two groups.Conclusion: The lung ultrasound score can accurately predict failure to wean critically ill COVID-19 patients off mechanical ventilation, whereas assessment of right hemidiaphragmatic excursion does not appear helpful in this regard.Trial Registration: https://clinicaltrials.gov/ct2/show/NCT05706441.Keywords: lung ultrasound score, diaphragmatic excursion, spontaneous breathing trial, weaning, COVID-19, critical care |
| first_indexed | 2024-03-07T23:29:18Z |
| format | Article |
| id | doaj.art-0c132a9d5eb842d59c724e027850e1b2 |
| institution | Directory Open Access Journal |
| issn | 1178-1998 |
| language | English |
| last_indexed | 2024-03-07T23:29:18Z |
| publishDate | 2024-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj.art-0c132a9d5eb842d59c724e027850e1b22024-02-20T17:10:12ZengDove Medical PressClinical Interventions in Aging1178-19982024-02-01Volume 1931332290542Lung Ultrasound Score as a Predictor of Failure to Wean COVID-19 Elderly Patients off Mechanical Ventilation: A Prospective Observational StudyWang YYi YZhang FYao YYChen YXWu CMWang RYYan MYing Wang,1,* Yu Yi,1,* Fan Zhang,1 Yuan-Yuan Yao,2 Yue-Xiu Chen,2 Chao-Min Wu,2 Rui-Yu Wang,2 Min Yan1,2 1Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, 221004, People’s Republic of China; 2Department of Anesthesiology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310016, People’s Republic of China*These authors contributed equally to this workCorrespondence: Min Yan, Email zryanmin@zju.edu.cnBackground: The lung ultrasound score was developed for rapidly assessing the extent of lung ventilation, and it can predict failure to wean various types of patients off mechanical ventilation. Whether it is also effective for COVID-19 patients is unclear.Methods: This single-center, prospective, observational study was conducted to assess the ability of the 12-region lung ultrasound score to predict failure to wean COVID-19 patients off ventilation. In parallel, we assessed whether right hemidiaphragmatic excursion or previously published predictors of weaning failure can apply to these patients. Predictive ability was assessed in terms of the area under the receiver operating characteristic curve (AUC).Results: The mean age of the 35 patients in the study was (75 ± 9) years and 12 patients (37%) could not be weaned off mechanical ventilation. The lung ultrasound score predicted these failures with an AUC of 0.885 (95% CI 0.770– 0.999, p < 0.001), and a threshold score of 10 provided specificity of 72.7% and sensitivity of 92.3%. AUCs were lower for previously published predictors of weaning failure, and right hemidiaphragmatic excursion did not differ significantly between the two groups.Conclusion: The lung ultrasound score can accurately predict failure to wean critically ill COVID-19 patients off mechanical ventilation, whereas assessment of right hemidiaphragmatic excursion does not appear helpful in this regard.Trial Registration: https://clinicaltrials.gov/ct2/show/NCT05706441.Keywords: lung ultrasound score, diaphragmatic excursion, spontaneous breathing trial, weaning, COVID-19, critical carehttps://www.dovepress.com/lung-ultrasound-score-as-a-predictor-of-failure-to-wean-covid-19-elder-peer-reviewed-fulltext-article-CIAlung ultrasound scorediaphragmatic excursionspontaneous breathing trialweaningcovid-19critical care |
| spellingShingle | Wang Y Yi Y Zhang F Yao YY Chen YX Wu CM Wang RY Yan M Lung Ultrasound Score as a Predictor of Failure to Wean COVID-19 Elderly Patients off Mechanical Ventilation: A Prospective Observational Study Clinical Interventions in Aging lung ultrasound score diaphragmatic excursion spontaneous breathing trial weaning covid-19 critical care |
| title | Lung Ultrasound Score as a Predictor of Failure to Wean COVID-19 Elderly Patients off Mechanical Ventilation: A Prospective Observational Study |
| title_full | Lung Ultrasound Score as a Predictor of Failure to Wean COVID-19 Elderly Patients off Mechanical Ventilation: A Prospective Observational Study |
| title_fullStr | Lung Ultrasound Score as a Predictor of Failure to Wean COVID-19 Elderly Patients off Mechanical Ventilation: A Prospective Observational Study |
| title_full_unstemmed | Lung Ultrasound Score as a Predictor of Failure to Wean COVID-19 Elderly Patients off Mechanical Ventilation: A Prospective Observational Study |
| title_short | Lung Ultrasound Score as a Predictor of Failure to Wean COVID-19 Elderly Patients off Mechanical Ventilation: A Prospective Observational Study |
| title_sort | lung ultrasound score as a predictor of failure to wean covid 19 elderly patients off mechanical ventilation a prospective observational study |
| topic | lung ultrasound score diaphragmatic excursion spontaneous breathing trial weaning covid-19 critical care |
| url | https://www.dovepress.com/lung-ultrasound-score-as-a-predictor-of-failure-to-wean-covid-19-elder-peer-reviewed-fulltext-article-CIA |
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