Ultrasonography for Screening and Follow-Up of Diaphragmatic Dysfunction in the ICU: A Pilot Study
| Autor: | Benjamin Planquette, Gilles Troché, Virgine Laurent, Kolia Milojevic, Lucie Fenet Mariani, Jean Pierre Bedos, Nicolas Lerolle, Jérôme Bedel, Julia Hilly, Antoine Gros |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Critical Care medicine.medical_treatment Critical Illness Diaphragm Diaphragmatic breathing Pilot Projects Critical Care and Intensive Care Medicine Risk Assessment Spontaneous breathing trial law.invention 03 medical and health sciences 0302 clinical medicine law medicine Weaning Humans Mass Screening Prospective Studies Simplified Acute Physiology Score Prospective cohort study Aged Ultrasonography Mechanical ventilation business.industry 030208 emergency & critical care medicine Middle Aged Intensive care unit Respiration Artificial Surgery Diaphragm (structural system) Intensive Care Units 030228 respiratory system Anesthesia Female France business Ventilator Weaning |
| Zdroj: | Journal of intensive care medicine. 31(5) |
| ISSN: | 1525-1489 |
| Popis: | Purpose: Reversibility and impact of diaphragmatic dysfunction (DD) are unknown. The principal aim was to describe diaphragmatic function as assessed by ultrasonography during weaning trials. Materials and Methods: The present study is a 6-month single-center prospective study. All patients under mechanical ventilation for more than 7 days and eligible for a spontaneous breathing trial (SBT) were enrolled prospectively. Intervention: Two blinded ultrasonographers evaluated each hemidiaphragm during SBT. Prevalence of DD among weaning failure and death and interobserver reproducibility have been evaluated. Results: The 34 included patients had a mean Simplified Acute Physiology Score version II of 55.7 ± 14 and a median intensive care unit (ICU) stay length of 17 days (13-30). Diaphragmatic dysfunction was found in 13 (38%) patients, on both sides in 8. Bilateral DD resolved before ICU discharge in 5 of the 7 reevaluated patients. No weaning failures were recorded. The ICU mortality was higher in patients with DD (37% vs 5%, P = .048). Mean interobserver agreement rate was 91%. Reproducibility was better with M-mode. Conclusion: The ICU-acquired DD usually improves before ICU discharge but might constitute a marker for greater disease severity. The present preliminary results require confirmation in a larger prospective multicenter study. |
| Databáze: | OpenAIRE |
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