Ultrasound Assessment of Diaphragm As A Predictor Tool Of Successful Extubation In Mechanically Ventilated Patients

Background Weaning failure is defined as failure to pass a spontaneous breathing trial or the need for re-intubation within 48 hours following extubation. An estimated 20% of all mechanically ventilated patients will encounter a failed extubation scenario. The pathophysiology of weaning failure...

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Main Author: Suang, Kuang Ting
Format: Thesis
Language:English
Published: 2021
Subjects:
Online Access:http://eprints.usm.my/58827/1/KUANG%20TING%20SUANG-24%20pages.pdf
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author Suang, Kuang Ting
author_facet Suang, Kuang Ting
author_sort Suang, Kuang Ting
collection USM
description Background Weaning failure is defined as failure to pass a spontaneous breathing trial or the need for re-intubation within 48 hours following extubation. An estimated 20% of all mechanically ventilated patients will encounter a failed extubation scenario. The pathophysiology of weaning failure is multifactorial but a recent factor of interest described in current literature is that of diaphragm dysfunction. The purpose of this study is to determine the role of ultrasound assessment of diaphragm as a predictor tool of successful extubation in mechanically ventilated patients Methods This study was carried out in Hospital Queen Elizabeth, Sabah and Hospital Universiti Sains Malaysia, Kelantan. Seventy-five mechanically ventilated patients who were planned for extubation and met the inclusion criteria were enrolled into the study. Written consent was obtained from the next of kin. Bedside diaphragmatic ultrasound was carried out prior to extubation to assess diaphragm excursion and diaphragm thickness fraction. The diaphragm ultrasound was performed by the clinician who had no role in the management of the patients. Extubation was based on intensivist’s or anaesthetist’s decision who were blinded of the ultrasound results. The patients were followed up for 48 hours post extubation. Results There was a statistically significant difference in both the mean diaphragm excursion and the mean diaphragm thickness fraction between the successful extubation group and the failed extubation group. When the diaphragm thickness fraction increased by 1 %, the chance of successful extubation increased by 1.29 times. Conclusion Ultrasound assessment of diaphragm thickening fraction can be used as a predictor tool of successful extubation in mechanically ventilated patients.
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spelling usm.eprints-588272023-07-06T04:57:02Z http://eprints.usm.my/58827/ Ultrasound Assessment of Diaphragm As A Predictor Tool Of Successful Extubation In Mechanically Ventilated Patients Suang, Kuang Ting QP Physiology Background Weaning failure is defined as failure to pass a spontaneous breathing trial or the need for re-intubation within 48 hours following extubation. An estimated 20% of all mechanically ventilated patients will encounter a failed extubation scenario. The pathophysiology of weaning failure is multifactorial but a recent factor of interest described in current literature is that of diaphragm dysfunction. The purpose of this study is to determine the role of ultrasound assessment of diaphragm as a predictor tool of successful extubation in mechanically ventilated patients Methods This study was carried out in Hospital Queen Elizabeth, Sabah and Hospital Universiti Sains Malaysia, Kelantan. Seventy-five mechanically ventilated patients who were planned for extubation and met the inclusion criteria were enrolled into the study. Written consent was obtained from the next of kin. Bedside diaphragmatic ultrasound was carried out prior to extubation to assess diaphragm excursion and diaphragm thickness fraction. The diaphragm ultrasound was performed by the clinician who had no role in the management of the patients. Extubation was based on intensivist’s or anaesthetist’s decision who were blinded of the ultrasound results. The patients were followed up for 48 hours post extubation. Results There was a statistically significant difference in both the mean diaphragm excursion and the mean diaphragm thickness fraction between the successful extubation group and the failed extubation group. When the diaphragm thickness fraction increased by 1 %, the chance of successful extubation increased by 1.29 times. Conclusion Ultrasound assessment of diaphragm thickening fraction can be used as a predictor tool of successful extubation in mechanically ventilated patients. 2021 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/58827/1/KUANG%20TING%20SUANG-24%20pages.pdf Suang, Kuang Ting (2021) Ultrasound Assessment of Diaphragm As A Predictor Tool Of Successful Extubation In Mechanically Ventilated Patients. Masters thesis, Universiti Sains Malaysia.
spellingShingle QP Physiology
Suang, Kuang Ting
Ultrasound Assessment of Diaphragm As A Predictor Tool Of Successful Extubation In Mechanically Ventilated Patients
title Ultrasound Assessment of Diaphragm As A Predictor Tool Of Successful Extubation In Mechanically Ventilated Patients
title_full Ultrasound Assessment of Diaphragm As A Predictor Tool Of Successful Extubation In Mechanically Ventilated Patients
title_fullStr Ultrasound Assessment of Diaphragm As A Predictor Tool Of Successful Extubation In Mechanically Ventilated Patients
title_full_unstemmed Ultrasound Assessment of Diaphragm As A Predictor Tool Of Successful Extubation In Mechanically Ventilated Patients
title_short Ultrasound Assessment of Diaphragm As A Predictor Tool Of Successful Extubation In Mechanically Ventilated Patients
title_sort ultrasound assessment of diaphragm as a predictor tool of successful extubation in mechanically ventilated patients
topic QP Physiology
url http://eprints.usm.my/58827/1/KUANG%20TING%20SUANG-24%20pages.pdf
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